CMS Formulary

Displaying 178181-178190 of 1611142 results.
ID: 178181
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 201185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178182
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 178183
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 178184
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 178185
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 178186
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 178187
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178188
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 178189
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 178190
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28