CMS Formulary

Displaying 26061-26070 of 1611142 results.
ID: 26061
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26062
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26063
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 352297
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26064
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26065
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26066
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26067
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26068
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26069
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26070
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30