CMS Formulary

Displaying 31471-31480 of 1611142 results.
ID: 31471
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31472
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31473
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31474
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31475
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31476
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31477
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31478
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 31479
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 31480
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28