CMS Formulary

Displaying 31931-31940 of 1611142 results.
ID: 31931
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31932
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31933
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31934
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31935
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31936
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31937
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31938
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31939
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31940
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30