CMS Formulary

Displaying 25301-25310 of 1611142 results.
ID: 25301
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117522
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25302
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664981
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25303
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25304
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25305
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25306
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25307
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25308
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25309
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25310
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30