CMS Formulary

Displaying 177691-177700 of 1611142 results.
ID: 177691
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177692
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177693
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177694
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177695
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177696
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177697
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177698
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177699
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177700
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30