CMS Formulary

Displaying 85441-85450 of 1611142 results.
ID: 85441
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85442
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85443
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85444
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85445
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85446
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85447
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85448
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85449
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85450
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30