CMS Formulary

Displaying 77291-77300 of 1611142 results.
ID: 77291
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77292
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77293
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77294
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77295
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 77296
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 77297
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77298
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77299
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77300
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30