CMS Formulary

Displaying 87031-87040 of 1611142 results.
ID: 87031
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 87032
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87033
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87034
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87035
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87036
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87037
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87038
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87039
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87040
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0