CMS Formulary

Displaying 177491-177500 of 1611142 results.
ID: 177491
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177492
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177493
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177494
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177495
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177496
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177497
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177498
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1440937
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177499
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1440183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177500
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0