CMS Formulary

Displaying 26361-26370 of 1611142 results.
ID: 26361
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 26362
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28
ID: 26363
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 26364
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26365
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 49
Qty Limit Days: 28
ID: 26366
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26367
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 70
Qty Limit Days: 28
ID: 26368
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 26369
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26370
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30