CMS Formulary

Displaying 25391-25400 of 1611142 results.
ID: 25391
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25392
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25393
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25394
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25395
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 25396
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25397
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 25398
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 25399
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 25400
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28