CMS Formulary

Displaying 28921-28930 of 1611142 results.
ID: 28921
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28922
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28923
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28924
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 28925
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28926
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28927
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28928
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28929
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28930
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0