CMS Formulary

Displaying 26681-26690 of 1611142 results.
ID: 26681
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26682
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26683
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26684
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26685
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26686
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26687
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 794639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26688
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26689
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26690
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0