CMS Formulary

Displaying 26901-26910 of 1611142 results.
ID: 26901
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 26902
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26903
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26904
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26905
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26906
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 26907
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 26908
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26909
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26910
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30