CMS Formulary

Displaying 179471-179480 of 1611142 results.
ID: 179471
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179472
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179473
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179474
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179475
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179476
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 180
ID: 179477
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 403875
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179478
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 179479
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179480
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0