CMS Formulary

Displaying 27801-27810 of 1611142 results.
ID: 27801
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27802
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27803
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27804
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27805
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27806
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 27807
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 27808
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 27809
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27810
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30