CMS Formulary

Displaying 28081-28090 of 1611142 results.
ID: 28081
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28082
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 727545
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28083
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28084
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649946
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28085
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28086
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180
ID: 28087
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28088
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28089
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28090
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0