CMS Formulary

Displaying 86321-86330 of 1611142 results.
ID: 86321
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86322
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86323
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86324
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86325
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86326
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86327
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86328
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1485332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86329
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86330
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0