CMS Formulary

Displaying 87751-87760 of 1611142 results.
ID: 87751
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 750268
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87752
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 761977
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87753
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 750265
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87754
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 762001
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87755
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 762334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87756
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 753483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87757
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 750267
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87758
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095229
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87759
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 857560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87760
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0