CMS Formulary

Displaying 84831-84840 of 1611142 results.
ID: 84831
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 597974
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84832
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 597987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84833
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 597977
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84834
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 597971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84835
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84836
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84837
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84838
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84839
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84840
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0