CMS Formulary

Displaying 77691-77700 of 1611142 results.
ID: 77691
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77692
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77693
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77694
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 77695
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77696
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77697
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77698
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77699
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77700
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0