CMS Formulary

Displaying 26601-26610 of 1611142 results.
ID: 26601
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 597850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26602
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26603
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26604
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26605
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866049
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26606
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896019
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26607
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896027
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26608
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896023
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26609
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26610
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 180