CMS Formulary

Displaying 77231-77240 of 1611142 results.
ID: 77231
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 730861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77232
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 730872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77233
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77234
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 900164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77235
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 850091
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77236
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 850087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77237
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77238
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77239
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77240
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0