CMS Formulary

Displaying 177861-177870 of 1611142 results.
ID: 177861
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1650282
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 177862
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 177863
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 177864
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177865
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 177866
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177867
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177868
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177869
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177870
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0