CMS Formulary

Displaying 177051-177060 of 1611142 results.
ID: 177051
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177052
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177053
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177054
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 177055
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177056
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177057
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177058
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177059
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177060
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0