CMS Formulary

Displaying 86001-86010 of 1611142 results.
ID: 86001
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86002
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86003
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399898
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86004
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86005
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86006
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86007
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 86008
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86009
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86010
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0