CMS Formulary

Displaying 85931-85940 of 1611142 results.
ID: 85931
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85932
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85933
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85934
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85935
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 85936
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 85937
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 85938
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 85939
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 85940
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30