CMS Formulary

Displaying 27211-27220 of 1611142 results.
ID: 27211
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27212
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27213
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27214
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27215
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 27216
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 27217
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27218
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27219
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27220
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30