CMS Formulary

Displaying 84011-84020 of 1611142 results.
ID: 84011
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84012
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84013
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84014
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84015
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84016
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84017
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84018
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84019
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84020
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0