CMS Formulary

Displaying 26911-26920 of 1611142 results.
ID: 26911
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26912
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26913
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26914
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26915
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26916
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26917
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26918
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26919
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26920
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0