CMS Formulary

Displaying 84771-84780 of 1611142 results.
ID: 84771
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 84772
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 84773
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84774
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84775
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84776
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84777
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84778
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84779
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84780
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30