CMS Formulary

Displaying 26431-26440 of 1611142 results.
ID: 26431
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26432
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26433
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26434
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26435
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26436
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26437
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26438
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26439
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 26440
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30