CMS Formulary

Displaying 31351-31360 of 1611142 results.
ID: 31351
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31352
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1865962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31353
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31354
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31355
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31356
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31357
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31358
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31359
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31360
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0