CMS Formulary

Displaying 85781-85790 of 1611142 results.
ID: 85781
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85782
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85783
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85784
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 85785
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 85786
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85787
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 85788
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85789
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85790
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0