CMS Formulary

Displaying 25511-25520 of 1611142 results.
ID: 25511
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25512
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 352066
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25513
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25514
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 25515
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 25516
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 25517
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25518
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25519
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 25520
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30