CMS Formulary

Displaying 25721-25730 of 1611142 results.
ID: 25721
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 25722
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25723
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 25724
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25725
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25726
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25727
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25728
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25729
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25730
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0