CMS Formulary

Displaying 26571-26580 of 1611142 results.
ID: 26571
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 26572
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 26573
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26574
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26575
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26576
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 26577
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26578
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26579
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26580
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28