CMS Formulary

Displaying 27681-27690 of 1611142 results.
ID: 27681
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27682
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27683
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 27684
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 27685
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27686
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27687
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 27688
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27689
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27690
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30