CMS Formulary

Displaying 31811-31820 of 1611142 results.
ID: 31811
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31812
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31813
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31814
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 31815
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 31816
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 31817
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 31818
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 31819
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31820
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30