CMS Formulary

Displaying 25131-25140 of 1611142 results.
ID: 25131
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25132
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605071
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25133
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25134
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 314072
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 25135
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 244967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25136
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25137
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25138
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25139
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25140
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0