CMS Formulary

Displaying 27841-27850 of 1611142 results.
ID: 27841
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27842
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 27843
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27844
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27845
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 27846
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 27847
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 27848
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 27849
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 27850
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28