CMS Formulary

Displaying 84661-84670 of 1611142 results.
ID: 84661
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 84662
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 84663
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84664
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84665
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84666
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84667
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84668
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84669
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84670
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0