CMS Formulary

Displaying 177391-177400 of 1611142 results.
ID: 177391
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177392
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177393
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1314768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 177394
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177395
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177396
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177397
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177398
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177399
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177400
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30