CMS Formulary

Displaying 85601-85610 of 1611142 results.
ID: 85601
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85602
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85603
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85604
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85605
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85606
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 85607
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85608
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85609
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85610
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0