CMS Formulary

Displaying 77791-77800 of 1611142 results.
ID: 77791
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77792
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77793
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77794
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77795
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77796
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77797
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77798
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77799
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77800
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0