CMS Formulary

Displaying 86511-86520 of 1611142 results.
ID: 86511
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86512
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86513
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 86514
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 180
ID: 86515
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 86516
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 86517
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 86518
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86519
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86520
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30