CMS Formulary

Displaying 25121-25130 of 1611142 results.
ID: 25121
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 25122
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 25123
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25124
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25125
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25126
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25127
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25128
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25129
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25130
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0