CMS Formulary

Displaying 77041-77050 of 1611142 results.
ID: 77041
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77042
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77043
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77044
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77045
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2171002
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77046
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77047
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77048
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77049
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77050
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 859867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0