CMS Formulary

Displaying 178091-178100 of 1611142 results.
ID: 178091
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 178092
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 178093
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 178094
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 178095
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178096
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178097
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178098
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178099
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 178100
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0