CMS Formulary

Displaying 31901-31910 of 1611142 results.
ID: 31901
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31902
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31903
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31904
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31905
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 31906
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 31907
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31908
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31909
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 31910
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30