CMS Formulary

Displaying 31361-31370 of 1611142 results.
ID: 31361
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31362
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31363
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31364
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31365
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31366
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31367
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31368
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31369
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31370
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30