CMS Formulary

Displaying 31671-31680 of 1611142 results.
ID: 31671
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31672
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31673
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31674
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31675
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31676
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31677
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 31678
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31679
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31680
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0