CMS Formulary

Displaying 26631-26640 of 1611142 results.
ID: 26631
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26632
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26633
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26634
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26635
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26636
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26637
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26638
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26639
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26640
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0