CMS Formulary

Displaying 28281-28290 of 1611142 results.
ID: 28281
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28282
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 28283
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28284
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28285
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28286
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28287
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28288
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28289
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28290
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0