CMS Formulary

Displaying 176351-176360 of 1611142 results.
ID: 176351
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176352
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176353
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176354
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176355
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176356
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176357
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2400
Qty Limit Days: 30
ID: 176358
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 176359
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176360
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30