CMS Formulary

Displaying 31451-31460 of 1611142 results.
ID: 31451
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31452
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31453
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31454
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31455
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31456
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31457
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 31458
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 31459
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274816
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31460
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28