CMS Formulary

Displaying 25251-25260 of 1611142 results.
ID: 25251
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25252
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25253
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25254
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25255
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 25256
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25257
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25258
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25259
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25260
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604384
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0