CMS Formulary

Displaying 177161-177170 of 1611142 results.
ID: 177161
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 643488
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177162
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177163
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177164
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177165
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177166
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177167
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177168
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177169
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177170
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0