CMS Formulary

Displaying 87521-87530 of 1611142 results.
ID: 87521
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87522
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87523
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87524
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87525
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87526
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87527
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87528
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87529
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87530
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28