CMS Formulary

Displaying 86291-86300 of 1611142 results.
ID: 86291
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 314203
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86292
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312749
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86293
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 199353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86294
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 199351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86295
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 199352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86296
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86297
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86298
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86299
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86300
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 853201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30