CMS Formulary

Displaying 77061-77070 of 1611142 results.
ID: 77061
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 562251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77062
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 617995
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77063
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77064
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77065
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77066
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 77067
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 77068
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77069
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 77070
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30