CMS Formulary

Displaying 176851-176860 of 1611142 results.
ID: 176851
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 847917
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 176852
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 847913
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 176853
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1990869
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 176854
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176855
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1729511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176856
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085773
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176857
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648999
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176858
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 486515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176859
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 730782
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176860
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0