CMS Formulary

Displaying 178361-178370 of 1611142 results.
ID: 178361
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 178362
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178363
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178364
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178365
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178366
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178367
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178368
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 178369
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178370
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0