CMS Formulary

Displaying 87341-87350 of 1611142 results.
ID: 87341
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87342
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87343
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87344
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2109239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87345
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 87346
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 87347
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87348
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87349
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87350
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0