CMS Formulary

Displaying 27571-27580 of 1611142 results.
ID: 27571
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27572
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27573
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27574
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27575
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27576
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27577
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27578
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27579
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27580
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0