CMS Formulary

Displaying 31591-31600 of 1611142 results.
ID: 31591
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 31592
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 31593
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 25
ID: 31594
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31595
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31596
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31597
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31598
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31599
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31600
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28