CMS Formulary

Displaying 176231-176240 of 1611142 results.
ID: 176231
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 731281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176232
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1652646
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176233
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176234
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176235
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1926332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176236
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 176237
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2380236
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176238
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2380260
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176239
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 311036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176240
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2380256
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0