CMS Formulary

Displaying 85421-85430 of 1611142 results.
ID: 85421
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85422
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85423
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 85424
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2120195
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 85425
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 85426
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 727537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85427
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648162
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85428
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648160
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85429
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048718
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85430
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048722
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30