CMS Formulary

Displaying 87651-87660 of 1611142 results.
ID: 87651
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87652
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87653
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87654
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87655
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87656
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87657
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87658
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87659
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 87660
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30