CMS Formulary

Displaying 87941-87950 of 1611142 results.
ID: 87941
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 87942
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87943
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87944
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 87945
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 87946
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 87947
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 87948
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 87949
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87950
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0