CMS Formulary

Displaying 25231-25240 of 1611142 results.
ID: 25231
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25232
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25233
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 686418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25234
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25235
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25236
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25237
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25238
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25239
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299911
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25240
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0