Displaying 163701-163710 of 1611142 results.
ID:
163701
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
582984
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163702
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2477272
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
163703
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
795749
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
163704
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1809520
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163705
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
239189
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163706
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1665107
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163707
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
309072
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163708
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
863538
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163709
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1665507
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163710
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1608276
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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