CMS Formulary

Displaying 28951-28960 of 1611142 results.
ID: 28951
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28952
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28953
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28954
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28955
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28956
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 28957
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28958
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28959
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28960
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0