CMS Formulary

Displaying 25191-25200 of 1611142 results.
ID: 25191
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25192
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25193
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25194
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25195
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25196
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25197
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25198
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25199
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25200
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0