CMS Formulary

Displaying 25791-25800 of 1611142 results.
ID: 25791
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25792
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 25793
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2393794
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 25794
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121764
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25795
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173841
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25796
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25797
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 25798
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 25799
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 25800
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28