CMS Formulary

Displaying 31431-31440 of 1611142 results.
ID: 31431
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31432
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31433
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049504
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31434
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31435
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31436
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31437
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31438
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31439
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31440
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0