CMS Formulary

Displaying 25241-25250 of 1611142 results.
ID: 25241
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25242
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25243
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360548
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25244
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25245
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25246
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25247
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25248
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25249
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25250
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30