CMS Formulary

Displaying 85271-85280 of 1611142 results.
ID: 85271
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85272
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85273
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85274
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85275
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85276
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85277
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85278
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85279
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85280
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0