CMS Formulary

Displaying 25021-25030 of 1611142 results.
ID: 25021
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 328161
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25022
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25023
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25024
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25025
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25026
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25027
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25028
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25029
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25030
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28