CMS Formulary

Displaying 77341-77350 of 1611142 results.
ID: 77341
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77342
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77343
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 77344
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 77345
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77346
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77347
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77348
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77349
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 77350
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30