CMS Formulary

Displaying 85311-85320 of 1611142 results.
ID: 85311
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115012
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 85312
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115013
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 85313
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85314
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85315
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85316
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85317
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85318
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 85319
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85320
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0