CMS Formulary

Displaying 31201-31210 of 1611142 results.
ID: 31201
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31202
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31203
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31204
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31205
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 31206
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 31207
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31208
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31209
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31210
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84