CMS Formulary

Displaying 28511-28520 of 1611142 results.
ID: 28511
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28512
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604384
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28513
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054159
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28514
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28515
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28516
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28517
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28518
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 825335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28519
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28520
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0