CMS Formulary

Displaying 25051-25060 of 1611142 results.
ID: 25051
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25052
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25053
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25054
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 25055
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25056
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25057
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25058
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25059
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25060
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0