CMS Formulary

Displaying 77771-77780 of 1611142 results.
ID: 77771
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77772
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77773
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77774
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 77775
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77776
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77777
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77778
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77779
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77780
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0