CMS Formulary

Displaying 77841-77850 of 1611142 results.
ID: 77841
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2397128
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77842
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314106
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77843
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311681
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77844
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77845
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77846
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 749783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77847
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 248656
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77848
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77849
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77850
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0