CMS Formulary

Displaying 85491-85500 of 1611142 results.
ID: 85491
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 85492
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85493
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85494
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85495
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85496
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85497
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85498
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85499
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85500
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365