CMS Formulary

Displaying 28301-28310 of 1611142 results.
ID: 28301
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28302
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28303
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28304
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28305
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28306
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 28307
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28308
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28309
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28310
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0