CMS Formulary

Displaying 84001-84010 of 1611142 results.
ID: 84001
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 84002
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84003
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84004
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84005
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84006
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84007
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84008
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84009
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84010
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0