CMS Formulary

Displaying 25161-25170 of 1611142 results.
ID: 25161
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25162
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25163
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25164
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25165
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25166
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25167
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 25168
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 25169
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 25170
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30