CMS Formulary

Displaying 31841-31850 of 1611142 results.
ID: 31841
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31842
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 31843
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 31844
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31845
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31846
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31847
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31848
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 31849
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 31850
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30