CMS Formulary

Displaying 77661-77670 of 1611142 results.
ID: 77661
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244634
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77662
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77663
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77664
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 77665
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 77666
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77667
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77668
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77669
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77670
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0