CMS Formulary

Displaying 28021-28030 of 1611142 results.
ID: 28021
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28022
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28023
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28024
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28025
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28026
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28027
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28028
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099686
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 28029
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099691
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 28030
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099697
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28