CMS Formulary

Displaying 25861-25870 of 1611142 results.
ID: 25861
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 25862
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25863
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25864
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25865
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25866
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25867
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25868
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25869
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25870
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0