Displaying 163501-163510 of 1611142 results.
ID:
163501
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1013930
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163502
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
310289
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163503
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1043025
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163504
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1043031
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163505
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1373016
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163506
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1372999
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163507
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
855858
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
163508
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
313306
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163509
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
348472
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163510
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
282401
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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