CMS Formulary

Displaying 25281-25290 of 1611142 results.
ID: 25281
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25282
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25283
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25284
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25285
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25286
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25287
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25288
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 25289
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25290
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0