CMS Formulary

Displaying 85051-85060 of 1611142 results.
ID: 85051
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85052
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85053
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85054
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 851750
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85055
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85056
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85057
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85058
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85059
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85060
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2104192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0