CMS Formulary

Displaying 87271-87280 of 1611142 results.
ID: 87271
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87272
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87273
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87274
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87275
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87276
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87277
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87278
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87279
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87280
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0