CMS Formulary

Displaying 26811-26820 of 1611142 results.
ID: 26811
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26812
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 26813
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26814
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26815
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 26816
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 26817
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 26818
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26819
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26820
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30