CMS Formulary

Displaying 84641-84650 of 1611142 results.
ID: 84641
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 84642
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 84643
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 84644
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 84645
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84646
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84647
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84648
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84649
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84650
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30