CMS Formulary

Displaying 31861-31870 of 1611142 results.
ID: 31861
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31862
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31863
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31864
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31865
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31866
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31867
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31868
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31869
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31870
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28