CMS Formulary

Displaying 28371-28380 of 1611142 results.
ID: 28371
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28372
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 28373
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 28374
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28375
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28376
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28377
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28378
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28379
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28380
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0