CMS Formulary

Displaying 85641-85650 of 1611142 results.
ID: 85641
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198318
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85642
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 85643
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 85644
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85645
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 311727
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85646
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85647
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85648
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85649
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85650
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0