CMS Formulary

Displaying 176521-176530 of 1611142 results.
ID: 176521
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 176522
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176523
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176524
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176525
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176526
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 176527
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176528
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176529
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 176530
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0