CMS Formulary

Displaying 31071-31080 of 1611142 results.
ID: 31071
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31072
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 31073
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 31074
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 31075
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31076
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31077
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 31078
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31079
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31080
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0