CMS Formulary

Displaying 27821-27830 of 1611142 results.
ID: 27821
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 27822
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 27823
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27824
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27825
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 27826
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27827
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27828
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27829
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27830
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0