CMS Formulary

Displaying 87631-87640 of 1611142 results.
ID: 87631
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87632
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87633
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87634
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87635
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87636
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87637
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87638
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87639
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87640
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30