CMS Formulary

Displaying 31221-31230 of 1611142 results.
ID: 31221
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31222
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31223
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31224
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31225
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31226
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31227
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31228
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31229
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31230
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0