CMS Formulary

Displaying 177481-177490 of 1611142 results.
ID: 177481
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177482
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 177483
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177484
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 643070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177485
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 212438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177486
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 212437
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177487
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177488
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197848
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177489
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177490
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0