CMS Formulary

Displaying 85811-85820 of 1611142 results.
ID: 85811
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85812
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85813
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85814
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85815
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85816
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85817
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85818
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 85819
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85820
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0