CMS Formulary

Displaying 27241-27250 of 1611142 results.
ID: 27241
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27242
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 27243
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27244
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006122
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27245
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 27246
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 27247
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27248
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 27249
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27250
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0