CMS Formulary

Displaying 26641-26650 of 1611142 results.
ID: 26641
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26642
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26643
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26644
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26645
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26646
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26647
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26648
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26649
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872261
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26650
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0