CMS Formulary

Displaying 85211-85220 of 1611142 results.
ID: 85211
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 85212
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85213
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 85214
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85215
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85216
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85217
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 861505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85218
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85219
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85220
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0