CMS Formulary

Displaying 26701-26710 of 1611142 results.
ID: 26701
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26702
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26703
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26704
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26705
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26706
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26707
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26708
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 26709
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 26710
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28