CMS Formulary

Displaying 26621-26630 of 1611142 results.
ID: 26621
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26622
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26623
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26624
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 26625
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26626
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26627
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26628
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2109239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26629
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 26630
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28