CMS Formulary

Displaying 77361-77370 of 1611142 results.
ID: 77361
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77362
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 897666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77363
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77364
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77365
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77366
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77367
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77368
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77369
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77370
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 896766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0