CMS Formulary

Displaying 176271-176280 of 1611142 results.
ID: 176271
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 176272
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176273
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176274
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 176275
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 176276
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176277
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176278
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176279
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176280
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30