CMS Formulary

Displaying 31781-31790 of 1611142 results.
ID: 31781
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 31782
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 31783
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31784
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31785
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31786
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31787
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31788
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31789
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31790
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0