CMS Formulary

Displaying 31711-31720 of 1611142 results.
ID: 31711
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 31712
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31713
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31714
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31715
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31716
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31717
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31718
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31719
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31720
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0