CMS Formulary

Displaying 86111-86120 of 1611142 results.
ID: 86111
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86112
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86113
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86114
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86115
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86116
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86117
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 86118
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 86119
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86120
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0