CMS Formulary

Displaying 25501-25510 of 1611142 results.
ID: 25501
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25502
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25503
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25504
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 25505
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25506
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25507
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25508
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25509
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25510
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30