CMS Formulary

Displaying 27701-27710 of 1611142 results.
ID: 27701
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27702
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27703
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27704
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 27705
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27706
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27707
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27708
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27709
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27710
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0