CMS Formulary

Displaying 176531-176540 of 1611142 results.
ID: 176531
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298099
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176532
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176533
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176534
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176535
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 746804
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 176536
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 746815
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 176537
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 746813
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 176538
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 790284
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 176539
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2196792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 176540
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2196592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30