CMS Formulary

Displaying 178641-178650 of 1611142 results.
ID: 178641
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 178642
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178643
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 28
ID: 178644
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178645
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178646
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178647
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 308739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178648
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178649
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178650
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0