CMS Formulary

Displaying 85431-85440 of 1611142 results.
ID: 85431
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85432
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1865962
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85433
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85434
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85435
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85436
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85437
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85438
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85439
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85440
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0