CMS Formulary

Displaying 26381-26390 of 1611142 results.
ID: 26381
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26382
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26383
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 26384
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26385
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26386
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26387
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26388
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26389
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26390
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 834022
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30