CMS Formulary

Displaying 86551-86560 of 1611142 results.
ID: 86551
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 86552
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 86553
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666545
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86554
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86555
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86556
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380617
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 86557
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86558
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86559
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 86560
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0