CMS Formulary

Displaying 28831-28840 of 1611142 results.
ID: 28831
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 28832
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28833
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28834
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28835
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28836
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28837
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28838
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28839
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28840
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0