CMS Formulary

Displaying 177471-177480 of 1611142 results.
ID: 177471
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177472
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177473
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 902741
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177474
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 902729
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177475
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 902736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177476
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1306898
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177477
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177478
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177479
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177480
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 808748
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30