CMS Formulary

Displaying 84541-84550 of 1611142 results.
ID: 84541
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84542
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84543
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84544
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84545
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 863628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84546
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 314080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84547
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190655
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84548
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 545236
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84549
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84550
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244616
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30