CMS Formulary

Displaying 26281-26290 of 1611142 results.
ID: 26281
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26282
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26283
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 26284
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 26285
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26286
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26287
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26288
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26289
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 26290
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0