CMS Formulary

Displaying 31151-31160 of 1611142 results.
ID: 31151
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31152
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 31153
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31154
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31155
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31156
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31157
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31158
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31159
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31160
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0