CMS Formulary

Displaying 26581-26590 of 1611142 results.
ID: 26581
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26582
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 26583
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 26584
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 26585
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 26586
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26587
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26588
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26589
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 26590
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28