CMS Formulary

Displaying 28381-28390 of 1611142 results.
ID: 28381
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28382
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28383
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28384
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605071
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28385
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28386
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314072
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 28387
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 244967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28388
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28389
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28390
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0