CMS Formulary

Displaying 26051-26060 of 1611142 results.
ID: 26051
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26052
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26053
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26054
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26055
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26056
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26057
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26058
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26059
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26060
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0