CMS Formulary

Displaying 28481-28490 of 1611142 results.
ID: 28481
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28482
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28483
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28484
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28485
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 686418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28486
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28487
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28488
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28489
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28490
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0