CMS Formulary

Displaying 28611-28620 of 1611142 results.
ID: 28611
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28612
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28613
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28614
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28615
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28616
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28617
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28618
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 28619
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399895
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 28620
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399898
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28