CMS Formulary

Displaying 28811-28820 of 1611142 results.
ID: 28811
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28812
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28813
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28814
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28815
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28816
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28817
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 28818
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28819
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 317174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28820
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312745
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30