CMS Formulary

Displaying 27151-27160 of 1611142 results.
ID: 27151
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27152
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 828755
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27153
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 828539
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27154
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27155
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 645884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27156
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 27157
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197411
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27158
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27159
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 403850
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27160
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 810090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0