CMS Formulary

Displaying 177651-177660 of 1611142 results.
ID: 177651
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177652
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177653
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177654
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177655
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177656
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177657
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177658
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177659
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177660
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30