CMS Formulary

Displaying 179501-179510 of 1611142 results.
ID: 179501
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 179502
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179503
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 311913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179504
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179505
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179506
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179507
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179508
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179509
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179510
Formulary ID: 00021078
Formulary Version: 13
Contract Year: 2021
RXCUI: 1790684
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0