CMS Formulary

Displaying 84981-84990 of 1611142 results.
ID: 84981
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607808
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84982
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 797641
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84983
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360588
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84984
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84985
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84986
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84987
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 84988
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 84989
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 84990
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0