CMS Formulary

Displaying 26241-26250 of 1611142 results.
ID: 26241
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26242
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26243
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26244
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 26245
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26246
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26247
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26248
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26249
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26250
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30