CMS Formulary

Displaying 179051-179060 of 1611142 results.
ID: 179051
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 179052
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179053
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 179054
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179055
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179056
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179057
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179058
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179059
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179060
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0