CMS Formulary

Displaying 28441-28450 of 1611142 results.
ID: 28441
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831248
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28442
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28443
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28444
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28445
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28446
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28447
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28448
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28449
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28450
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0