CMS Formulary

Displaying 84901-84910 of 1611142 results.
ID: 84901
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84902
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 84903
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 84904
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 84905
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84906
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84907
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 84908
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84909
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 84910
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197575
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30