CMS Formulary

Displaying 84611-84620 of 1611142 results.
ID: 84611
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84612
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1375922
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84613
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 863042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84614
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84615
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84616
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84617
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84618
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84619
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84620
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0