CMS Formulary

Displaying 28861-28870 of 1611142 results.
ID: 28861
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28862
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28863
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28864
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28865
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28866
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28867
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28868
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28869
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28870
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309080
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0