CMS Formulary

Displaying 26561-26570 of 1611142 results.
ID: 26561
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26562
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26563
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26564
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26565
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26566
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 103401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26567
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26568
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26569
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311033
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 26570
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311027
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28