CMS Formulary

Displaying 27901-27910 of 1611142 results.
ID: 27901
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 27902
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 27903
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 27904
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 27905
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27906
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 27907
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 27908
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27909
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 27910
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0