CMS Formulary

Displaying 25401-25410 of 1611142 results.
ID: 25401
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 25402
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25403
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25404
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25405
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25406
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 25407
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25408
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 25409
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 25410
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28