CMS Formulary

Displaying 26751-26760 of 1611142 results.
ID: 26751
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26752
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 26753
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26754
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26755
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26756
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26757
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26758
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26759
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26760
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0