CMS Formulary

Displaying 87161-87170 of 1611142 results.
ID: 87161
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87162
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87163
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87164
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87165
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87166
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 87167
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 87168
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 87169
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87170
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0