CMS Formulary

Displaying 25871-25880 of 1611142 results.
ID: 25871
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25872
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25873
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25874
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25875
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25876
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 25877
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 25878
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855072
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25879
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986331
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25880
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918230
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30