CMS Formulary

Displaying 26691-26700 of 1611142 results.
ID: 26691
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26692
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26693
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26694
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26695
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26696
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 26697
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26698
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26699
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26700
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30