CMS Formulary

Displaying 77611-77620 of 1611142 results.
ID: 77611
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77612
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77613
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77614
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77615
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77616
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77617
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77618
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 252479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77619
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77620
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30