CMS Formulary

Displaying 87241-87250 of 1611142 results.
ID: 87241
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87242
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87243
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87244
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87245
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87246
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87247
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87248
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87249
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2700
Qty Limit Days: 30
ID: 87250
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0