CMS Formulary

Displaying 28851-28860 of 1611142 results.
ID: 28851
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046370
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28852
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28853
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28854
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28855
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28856
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28857
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28858
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28859
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30
ID: 28860
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30