CMS Formulary

Displaying 179731-179740 of 1611142 results.
ID: 179731
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179732
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179733
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 179734
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 179735
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 179736
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 179737
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 179738
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179739
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 904465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 179740
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30