CMS Formulary

Displaying 177511-177520 of 1611142 results.
ID: 177511
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 177512
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177513
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177514
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177515
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177516
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177517
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177518
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177519
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177520
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0