CMS Formulary

Displaying 31771-31780 of 1611142 results.
ID: 31771
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31772
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31773
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31774
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31775
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31776
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31777
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31778
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31779
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31780
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28