CMS Formulary

Displaying 25431-25440 of 1611142 results.
ID: 25431
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25432
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25433
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25434
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25435
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25436
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 25437
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 25438
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 25439
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25440
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0