CMS Formulary

Displaying 84131-84140 of 1611142 results.
ID: 84131
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84132
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84133
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84134
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84135
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84136
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84137
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84138
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 753482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84139
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 750268
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84140
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 761977
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0