CMS Formulary

Displaying 85631-85640 of 1611142 results.
ID: 85631
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85632
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85633
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85634
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349514
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85635
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85636
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85637
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85638
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 308459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85639
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 141963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85640
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198317
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30