CMS Formulary

Displaying 180171-180180 of 1611142 results.
ID: 180171
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 180172
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 180173
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 180174
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 180175
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 180176
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 180177
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 180178
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 180179
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 180180
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0