CMS Formulary

Displaying 26671-26680 of 1611142 results.
ID: 26671
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26672
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 26673
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 834350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26674
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26675
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26676
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26677
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 26678
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26679
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26680
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0