CMS Formulary

Displaying 178651-178660 of 1611142 results.
ID: 178651
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 30
ID: 178652
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 178653
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178654
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178655
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 178656
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 260218
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 178657
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 205324
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 178658
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 178659
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 178660
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30