CMS Formulary

Displaying 25671-25680 of 1611142 results.
ID: 25671
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25672
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 25673
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25674
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25675
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25676
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25677
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25678
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25679
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25680
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0