CMS Formulary

Displaying 26801-26810 of 1611142 results.
ID: 26801
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 26802
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 26803
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 26804
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26805
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26806
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26807
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26808
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26809
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26810
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30