CMS Formulary

Displaying 26041-26050 of 1611142 results.
ID: 26041
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 26042
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 26043
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 26044
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26045
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26046
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26047
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26048
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26049
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26050
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30