CMS Formulary

Displaying 27511-27520 of 1611142 results.
ID: 27511
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27512
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 27513
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 27514
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27515
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27516
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27517
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27518
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27519
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 27520
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0