CMS Formulary

Displaying 179771-179780 of 1611142 results.
ID: 179771
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 2475852
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 179772
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 179773
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992821
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 179774
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992695
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 179775
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992703
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 179776
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992691
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 179777
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992700
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 179778
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179779
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179780
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0