CMS Formulary

Displaying 85231-85240 of 1611142 results.
ID: 85231
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85232
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85233
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 834348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85234
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370767
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85235
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85236
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85237
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85238
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85239
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85240
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0