CMS Formulary

Displaying 177961-177970 of 1611142 results.
ID: 177961
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 310362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 177962
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177963
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1435115
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 177964
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177965
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177966
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177967
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177968
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177969
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 177970
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300468
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0