CMS Formulary

Displaying 25311-25320 of 1611142 results.
ID: 25311
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 25312
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 25313
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 25314
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 25315
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25316
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25317
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25318
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25319
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25320
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30