CMS Formulary

Displaying 177441-177450 of 1611142 results.
ID: 177441
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177442
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177443
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177444
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177445
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177446
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177447
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177448
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177449
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177450
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0