CMS Formulary

Displaying 31091-31100 of 1611142 results.
ID: 31091
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 31092
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 31093
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31094
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 31095
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31096
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31097
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 31098
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 31099
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 31100
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28