CMS Formulary

Displaying 86031-86040 of 1611142 results.
ID: 86031
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 86032
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86033
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86034
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86035
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86036
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86037
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 86038
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 86039
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86040
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0