CMS Formulary

Displaying 26441-26450 of 1611142 results.
ID: 26441
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26442
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26443
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26444
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26445
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309958
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26446
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26447
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 26448
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26449
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26450
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0