CMS Formulary

Displaying 26371-26380 of 1611142 results.
ID: 26371
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123314
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26372
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121096
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 26373
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121100
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26374
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390954
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 26375
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26376
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26377
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26378
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26379
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26380
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0