CMS Formulary

Displaying 26711-26720 of 1611142 results.
ID: 26711
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26712
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26713
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26714
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26715
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26716
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26717
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26718
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 26719
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 26720
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0