CMS Formulary

Displaying 31501-31510 of 1611142 results.
ID: 31501
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31502
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31503
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1052660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31504
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1250723
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31505
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31506
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31507
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31508
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31509
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31510
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0