CMS Formulary

Displaying 26321-26330 of 1611142 results.
ID: 26321
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 845518
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 26322
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 26323
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26324
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 860244
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 26325
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 26326
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 26327
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26328
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1119402
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 26329
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 26330
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28