CMS Formulary

Displaying 77681-77690 of 1611142 results.
ID: 77681
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77682
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77683
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 77684
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77685
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 77686
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197575
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 77687
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77688
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 77689
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77690
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 477451
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30