CMS Formulary

Displaying 28641-28650 of 1611142 results.
ID: 28641
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28642
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28643
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28644
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28645
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28646
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28647
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 28648
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28649
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 28650
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28