CMS Formulary

Displaying 27851-27860 of 1611142 results.
ID: 27851
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 27852
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 27853
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 27854
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 27855
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 27856
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27857
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27858
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27859
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 27860
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0