CMS Formulary

Displaying 28411-28420 of 1611142 results.
ID: 28411
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28412
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28413
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28414
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28415
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28416
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28417
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28418
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28419
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28420
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28