CMS Formulary

Displaying 26331-26340 of 1611142 results.
ID: 26331
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 26332
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26333
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26334
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26335
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26336
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26337
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26338
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26339
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26340
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0