CMS Formulary

Displaying 179431-179440 of 1611142 results.
ID: 179431
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 179432
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179433
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179434
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 311382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179435
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1366550
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179436
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 179437
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179438
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179439
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179440
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0