CMS Formulary

Displaying 25101-25110 of 1611142 results.
ID: 25101
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25102
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25103
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25104
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25105
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25106
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25107
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25108
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25109
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25110
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0