CMS Formulary

Displaying 86431-86440 of 1611142 results.
ID: 86431
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86432
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86433
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86434
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86435
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86436
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86437
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86438
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86439
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86440
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0