CMS Formulary

Displaying 26171-26180 of 1611142 results.
ID: 26171
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26172
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 10
ID: 26173
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26174
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30
ID: 26175
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26176
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26177
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26178
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26179
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26180
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 700
Qty Limit Days: 30