CMS Formulary

Displaying 31621-31630 of 1611142 results.
ID: 31621
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31622
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31623
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31624
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 31625
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 31626
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 31627
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31628
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31629
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31630
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0