CMS Formulary

Displaying 25701-25710 of 1611142 results.
ID: 25701
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25702
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25703
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25704
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 25705
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25706
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25707
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25708
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25709
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25710
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0