CMS Formulary

Displaying 87011-87020 of 1611142 results.
ID: 87011
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87012
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87013
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87014
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87015
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87016
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87017
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87018
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87019
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87020
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28