CMS Formulary

Displaying 177561-177570 of 1611142 results.
ID: 177561
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 545236
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177562
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1724340
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 177563
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 312075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177564
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 308345
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177565
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177566
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177567
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177568
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177569
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 884526
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177570
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1090641
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0