CMS Formulary

Displaying 85281-85290 of 1611142 results.
ID: 85281
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85282
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 993943
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 85283
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 994239
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 85284
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85285
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012904
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85286
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85287
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 85288
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 85289
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 85290
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0