CMS Formulary

Displaying 77311-77320 of 1611142 results.
ID: 77311
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77312
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77313
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77314
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77315
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77316
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77317
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77318
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77319
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77320
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0