CMS Formulary

Displaying 176831-176840 of 1611142 results.
ID: 176831
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 176832
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176833
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176834
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176835
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176836
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 176837
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 176838
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 176839
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 858044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176840
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 858040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30