CMS Formulary

Displaying 26011-26020 of 1611142 results.
ID: 26011
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 26012
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26013
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26014
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26015
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26016
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26017
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 26018
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 26019
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 26020
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0