CMS Formulary

Displaying 25851-25860 of 1611142 results.
ID: 25851
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25852
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25853
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25854
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25855
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25856
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25857
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25858
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 25859
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25860
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0