CMS Formulary

Displaying 26231-26240 of 1611142 results.
ID: 26231
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26232
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26233
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243010
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 26234
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243014
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26235
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 26236
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 26237
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 26238
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26239
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26240
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30