Displaying 158841-158850 of 1611142 results.
ID:
158841
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
1425118
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
158842
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
867506
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
158843
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
672152
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
158844
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
1425230
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
158845
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
1425228
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
158846
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
1245003
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
158847
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
825425
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
158848
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
825429
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
158849
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
884619
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
158850
Formulary ID:
00021064
Formulary Version:
15
Contract Year:
2021
RXCUI:
2121061
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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