CMS Formulary

Displaying 86011-86020 of 1611142 results.
ID: 86011
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 86012
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86013
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 86014
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86015
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86016
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86017
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86018
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 86019
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 86020
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0