CMS Formulary

Displaying 26271-26280 of 1611142 results.
ID: 26271
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 26272
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 26273
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 26274
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 26275
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 26276
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26277
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26278
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26279
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26280
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30