CMS Formulary

Displaying 26021-26030 of 1611142 results.
ID: 26021
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 26022
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 26023
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26024
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 26025
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 26026
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 26027
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047247
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26028
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256947
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 26029
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 26030
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256943
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30