CMS Formulary

Displaying 31381-31390 of 1611142 results.
ID: 31381
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31382
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31383
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31384
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31385
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31386
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31387
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31388
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31389
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31390
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0