CMS Formulary

Displaying 26401-26410 of 1611142 results.
ID: 26401
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26402
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26403
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26404
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26405
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26406
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26407
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 26408
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26409
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26410
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0