CMS Formulary

Displaying 177351-177360 of 1611142 results.
ID: 177351
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 892494
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177352
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 892596
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177353
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 892345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177354
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 894801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177355
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 892352
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177356
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 894814
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177357
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 892554
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177358
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177359
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177360
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0