Displaying 153221-153230 of 1611142 results.
ID:
153221
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
311995
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
365
ID:
153222
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
1648759
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
365
ID:
153223
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
903847
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
153224
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
1307061
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
62
Qty Limit Days:
31
ID:
153225
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
1115698
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1080
Qty Limit Days:
365
ID:
153226
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
1308569
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
153227
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
351209
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
153228
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
310362
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
28
ID:
153229
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
197623
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
153230
Formulary ID:
00021062
Formulary Version:
15
Contract Year:
2021
RXCUI:
1232585
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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