CMS Formulary

Displaying 177851-177860 of 1611142 results.
ID: 177851
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 248642
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177852
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 177853
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177854
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 177855
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177856
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177857
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177858
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177859
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 758032
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 177860
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28