CMS Formulary

Displaying 77431-77440 of 1611142 results.
ID: 77431
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77432
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77433
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77434
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77435
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77436
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77437
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77438
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77439
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77440
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0