CMS Formulary

Displaying 25411-25420 of 1611142 results.
ID: 25411
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25412
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 25413
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 25414
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 25415
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 25416
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365
ID: 25417
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25418
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25419
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25420
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0