CMS Formulary

Displaying 31101-31110 of 1611142 results.
ID: 31101
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 31102
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 31103
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 31104
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 31105
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 31106
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 31107
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 31108
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31109
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31110
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30