CMS Formulary

Displaying 25341-25350 of 1611142 results.
ID: 25341
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25342
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25343
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25344
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25345
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25346
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25347
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25348
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 25349
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 25350
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28