CMS Formulary

Displaying 85401-85410 of 1611142 results.
ID: 85401
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85402
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85403
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85404
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85405
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85406
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85407
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1668238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85408
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85409
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85410
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0