CMS Formulary

Displaying 86081-86090 of 1611142 results.
ID: 86081
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86082
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86083
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86084
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86085
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86086
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86087
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86088
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86089
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86090
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0