CMS Formulary

Displaying 26841-26850 of 1611142 results.
ID: 26841
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 26842
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 26843
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 26844
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 26845
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26846
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 26847
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26848
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26849
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 26850
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30