CMS Formulary

Displaying 177261-177270 of 1611142 results.
ID: 177261
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177262
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177263
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177264
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177265
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 859315
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 177266
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 177267
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177268
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177269
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177270
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0