CMS Formulary

Displaying 84101-84110 of 1611142 results.
ID: 84101
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84102
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84103
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84104
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84105
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84106
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84107
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84108
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84109
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84110
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30