CMS Formulary

Displaying 26301-26310 of 1611142 results.
ID: 26301
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26302
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940709
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 26303
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26304
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26305
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26306
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26307
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26308
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26309
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26310
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0