CMS Formulary

Displaying 31581-31590 of 1611142 results.
ID: 31581
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31582
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31583
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31584
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 31585
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31586
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31587
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31588
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31589
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 31590
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28