CMS Formulary

Displaying 31241-31250 of 1611142 results.
ID: 31241
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31242
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31243
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31244
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31245
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31246
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31247
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31248
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 31249
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 31250
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0