CMS Formulary

Displaying 87721-87730 of 1611142 results.
ID: 87721
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87722
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87723
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87724
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 87725
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87726
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87727
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87728
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87729
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87730
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0