CMS Formulary

Displaying 85481-85490 of 1611142 results.
ID: 85481
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85482
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85483
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85484
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928689
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85485
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118741
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85486
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 85487
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 85488
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85489
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 85490
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28