CMS Formulary

Displaying 176671-176680 of 1611142 results.
ID: 176671
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176672
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 359493
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 176673
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 359494
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 176674
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176675
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176676
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176677
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197975
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176678
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 176679
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1303736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 176680
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0