CMS Formulary

Displaying 28121-28130 of 1611142 results.
ID: 28121
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28122
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28123
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28124
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28125
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28126
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28127
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28128
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28129
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28130
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0