CMS Formulary

Displaying 85351-85360 of 1611142 results.
ID: 85351
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099691
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 85352
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099697
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 85353
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85354
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85355
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85356
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85357
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85358
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85359
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85360
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 199370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0