CMS Formulary

Displaying 26081-26090 of 1611142 results.
ID: 26081
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26082
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26083
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 26084
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26085
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26086
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988671
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 26087
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988675
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 26088
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26089
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26090
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0