CMS Formulary

Displaying 86911-86920 of 1611142 results.
ID: 86911
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86912
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197577
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86913
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 343033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86914
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197579
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86915
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86916
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86917
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86918
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86919
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86920
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197860
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0