CMS Formulary

Displaying 25771-25780 of 1611142 results.
ID: 25771
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25772
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25773
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25774
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111642
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25775
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 25776
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 25777
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25778
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25779
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25780
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30