CMS Formulary

Displaying 27521-27530 of 1611142 results.
ID: 27521
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27522
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 27523
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 27524
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 27525
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27526
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27527
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27528
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 27529
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27530
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0