CMS Formulary

Displaying 31401-31410 of 1611142 results.
ID: 31401
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31402
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31403
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31404
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31405
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31406
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31407
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31408
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31409
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31410
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365