CMS Formulary

Displaying 181471-181480 of 1611142 results.
ID: 181471
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244634
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181472
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181473
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181474
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181475
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 181476
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181477
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181478
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181479
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181480
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797895
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30