CMS Formulary

Displaying 26001-26010 of 1611142 results.
ID: 26001
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26002
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26003
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26004
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26005
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 26006
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26007
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26008
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26009
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 26010
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30