CMS Formulary

Displaying 27421-27430 of 1611142 results.
ID: 27421
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27422
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 27423
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27424
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27425
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27426
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27427
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27428
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27429
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27430
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0