CMS Formulary

Displaying 87371-87380 of 1611142 results.
ID: 87371
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098608
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87372
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87373
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87374
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87375
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 87376
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198057
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87377
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87378
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198059
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87379
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87380
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0