CMS Formulary

Displaying 87141-87150 of 1611142 results.
ID: 87141
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87142
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87143
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 757707
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87144
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 403957
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87145
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87146
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87147
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 87148
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87149
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87150
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0