CMS Formulary

Displaying 84601-84610 of 1611142 results.
ID: 84601
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25
ID: 84602
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 213262
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84603
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84604
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84605
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84606
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84607
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988399
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 84608
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84609
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118539
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84610
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0