CMS Formulary

Displaying 177091-177100 of 1611142 results.
ID: 177091
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177092
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 859983
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177093
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 859979
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177094
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 177095
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1608333
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177096
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177097
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177098
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177099
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177100
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0