CMS Formulary

Displaying 86971-86980 of 1611142 results.
ID: 86971
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 86972
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 86973
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 86974
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 86975
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 86976
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 86977
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 86978
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 86979
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 86980
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30