CMS Formulary

Displaying 28111-28120 of 1611142 results.
ID: 28111
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28112
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28113
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28114
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28115
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28116
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28117
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28118
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 28119
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28120
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0