CMS Formulary

Displaying 87541-87550 of 1611142 results.
ID: 87541
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87542
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 87543
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 87544
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 87545
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 87546
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87547
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87548
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87549
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87550
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0