CMS Formulary

Displaying 26611-26620 of 1611142 results.
ID: 26611
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26612
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26613
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26614
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 26615
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 26616
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 26617
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 26618
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 26619
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 26620
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30