CMS Formulary

Displaying 177191-177200 of 1611142 results.
ID: 177191
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177192
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177193
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177194
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177195
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177196
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177197
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177198
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177199
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 177200
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0