CMS Formulary

Displaying 27861-27870 of 1611142 results.
ID: 27861
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 27862
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 27863
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 27864
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 84
ID: 27865
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27866
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27867
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 27868
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27869
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 27870
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 795085
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0