CMS Formulary

Displaying 28331-28340 of 1611142 results.
ID: 28331
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28332
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 28333
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28334
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28335
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28336
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28337
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 28338
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 28339
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 28340
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25