CMS Formulary

Displaying 28321-28330 of 1611142 results.
ID: 28321
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28322
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28323
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28324
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28325
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28326
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28327
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28328
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28329
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28330
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0