CMS Formulary

Displaying 25831-25840 of 1611142 results.
ID: 25831
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25832
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25833
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 25834
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25835
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25836
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25837
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25838
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25839
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 25840
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0