CMS Formulary

Displaying 25741-25750 of 1611142 results.
ID: 25741
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25742
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25743
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25744
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25745
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25746
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25747
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25748
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25749
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25750
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28