CMS Formulary

Displaying 25761-25770 of 1611142 results.
ID: 25761
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25762
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25763
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 25764
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25765
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 25766
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 25767
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25768
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25769
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25770
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0