CMS Formulary

Displaying 28631-28640 of 1611142 results.
ID: 28631
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28632
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28633
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28634
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28635
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28636
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 28637
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28638
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 28639
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28640
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30