CMS Formulary

Displaying 26341-26350 of 1611142 results.
ID: 26341
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26342
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26343
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26344
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26345
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26346
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26347
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 825425
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26348
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 825429
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26349
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 884619
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26350
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121061
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28