CMS Formulary

Displaying 27411-27420 of 1611142 results.
ID: 27411
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27412
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27413
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27414
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27415
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27416
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27417
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27418
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27419
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27420
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30