CMS Formulary

Displaying 87101-87110 of 1611142 results.
ID: 87101
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87102
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87103
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87104
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87105
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87106
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87107
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87108
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87109
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87110
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30