CMS Formulary

Displaying 26261-26270 of 1611142 results.
ID: 26261
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26262
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26263
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26264
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26265
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26266
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26267
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26268
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26269
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 26270
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28