CMS Formulary

Displaying 28791-28800 of 1611142 results.
ID: 28791
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28792
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28793
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28794
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28795
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28796
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28797
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28798
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28799
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28800
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28