CMS Formulary

Displaying 26351-26360 of 1611142 results.
ID: 26351
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26352
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859501
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 26353
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1919094
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 26354
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169314
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 26355
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 26356
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26357
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 26358
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26359
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26360
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0