CMS Formulary

Displaying 28451-28460 of 1611142 results.
ID: 28451
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28452
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28453
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28454
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28455
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28456
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28457
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28458
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28459
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28460
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30