CMS Formulary

Displaying 84861-84870 of 1611142 results.
ID: 84861
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84862
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84863
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122659
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84864
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122657
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84865
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122655
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84866
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84867
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122648
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84868
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122642
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84869
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 84870
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0