CMS Formulary

Displaying 87691-87700 of 1611142 results.
ID: 87691
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 87692
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87693
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87694
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87695
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87696
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 87697
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87698
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87699
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 87700
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30