CMS Formulary

Displaying 28801-28810 of 1611142 results.
ID: 28801
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28802
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28803
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28804
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28805
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28806
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28807
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28808
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28809
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28810
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0