CMS Formulary

Displaying 85521-85530 of 1611142 results.
ID: 85521
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85522
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85523
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049504
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85524
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049545
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85525
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85526
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85527
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85528
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85529
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85530
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0