CMS Formulary

Displaying 84451-84460 of 1611142 results.
ID: 84451
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 84452
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 84453
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 84454
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 730866
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84455
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 730861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84456
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 730872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84457
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84458
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 900164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84459
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 850091
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84460
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 850087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0