CMS Formulary

Displaying 31141-31150 of 1611142 results.
ID: 31141
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31142
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31143
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31144
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 31145
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 31146
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359340
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 31147
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 31148
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31149
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31150
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28