CMS Formulary

Displaying 25471-25480 of 1611142 results.
ID: 25471
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25472
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25473
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25474
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25475
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25476
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25477
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25478
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25479
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25480
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0