CMS Formulary

Displaying 26791-26800 of 1611142 results.
ID: 26791
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 26792
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 26793
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 26794
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26795
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26796
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26797
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26798
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26799
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26800
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28