CMS Formulary

Displaying 28251-28260 of 1611142 results.
ID: 28251
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1052660
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28252
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1250723
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28253
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28254
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28255
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28256
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28257
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28258
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28259
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28260
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0