CMS Formulary

Displaying 25381-25390 of 1611142 results.
ID: 25381
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25382
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25383
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25384
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 25385
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25386
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 25387
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25388
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30
ID: 25389
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25390
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0