CMS Formulary

Displaying 31121-31130 of 1611142 results.
ID: 31121
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31122
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 795085
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31123
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 849599
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31124
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31125
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31126
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31127
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31128
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31129
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31130
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30