CMS Formulary

Displaying 176961-176970 of 1611142 results.
ID: 176961
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 618552
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176962
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176963
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176964
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176965
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 176966
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 176967
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 176968
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176969
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 176970
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0