CMS Formulary

Displaying 31131-31140 of 1611142 results.
ID: 31131
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 31132
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 31133
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31134
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31135
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31136
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31137
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31138
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31139
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31140
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30