CMS Formulary

Displaying 26131-26140 of 1611142 results.
ID: 26131
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26132
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26133
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26134
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 26135
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 26136
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26137
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26138
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26139
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26140
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0