CMS Formulary

Displaying 31871-31880 of 1611142 results.
ID: 31871
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399895
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31872
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399898
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31873
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31874
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31875
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31876
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 31877
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31878
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31879
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31880
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30