CMS Formulary

Displaying 26251-26260 of 1611142 results.
ID: 26251
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2469340
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26252
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 26253
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 26254
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 26255
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26256
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 26257
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26258
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26259
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26260
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28