CMS Formulary

Displaying 31391-31400 of 1611142 results.
ID: 31391
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31392
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31393
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31394
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928689
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31395
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31396
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31397
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31398
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31399
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31400
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28