CMS Formulary

Displaying 31681-31690 of 1611142 results.
ID: 31681
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31682
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31683
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31684
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31685
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 31686
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31687
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31688
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31689
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31690
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0