CMS Formulary

Displaying 26821-26830 of 1611142 results.
ID: 26821
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26822
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26823
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 26824
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 26825
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 26826
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26827
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26828
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26829
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26830
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0