CMS Formulary

Displaying 28901-28910 of 1611142 results.
ID: 28901
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28902
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28903
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28904
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28905
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28906
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28907
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28908
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28909
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28910
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0