CMS Formulary

Displaying 27471-27480 of 1611142 results.
ID: 27471
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27472
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27473
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 27474
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27475
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27476
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27477
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27478
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 27479
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27480
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30