CMS Formulary

Displaying 77271-77280 of 1611142 results.
ID: 77271
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77272
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77273
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77274
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77275
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77276
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 77277
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77278
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77279
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77280
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0