CMS Formulary

Displaying 25421-25430 of 1611142 results.
ID: 25421
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25422
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25423
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25424
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25425
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25426
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25427
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25428
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25429
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25430
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0