CMS Formulary

Displaying 85901-85910 of 1611142 results.
ID: 85901
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85902
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85903
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 85904
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85905
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85906
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 85907
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 483427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85908
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 483425
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85909
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 309140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85910
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0