CMS Formulary

Displaying 31751-31760 of 1611142 results.
ID: 31751
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31752
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31753
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31754
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31755
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31756
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31757
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31758
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31759
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 31760
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0