CMS Formulary

Displaying 180391-180400 of 1611142 results.
ID: 180391
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 858040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 180392
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1043567
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 180393
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1043582
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 180394
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1043574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 180395
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 180396
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 180397
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 180398
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 180399
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 180400
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30