Displaying 162701-162710 of 1611142 results.
ID:
162701
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
847913
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
162702
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1990869
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
162703
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
861045
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
162704
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
861043
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
162705
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
206347
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
162706
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1729511
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
162707
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1085773
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
162708
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1648999
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
162709
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
486515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
162710
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
730782
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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