CMS Formulary

Displaying 25881-25890 of 1611142 results.
ID: 25881
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25882
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 25883
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 25884
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944382
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25885
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25886
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 25887
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25888
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099026
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25889
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25890
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006065
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0