CMS Formulary

Displaying 87291-87300 of 1611142 results.
ID: 87291
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 87292
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 87293
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 87294
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 87295
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 87296
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 87297
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 87298
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 87299
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 87300
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28