CMS Formulary

Displaying 84811-84820 of 1611142 results.
ID: 84811
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84812
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84813
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84814
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 84815
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84816
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84817
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84818
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84819
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84820
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0