CMS Formulary

Displaying 176331-176340 of 1611142 results.
ID: 176331
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176332
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176333
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 205739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176334
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 352228
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176335
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176336
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176337
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176338
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176339
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176340
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0