Displaying 163901-163910 of 1611142 results.
ID:
163901
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1242819
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
30
ID:
163902
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1242815
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
163903
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
616749
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
163904
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
728231
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
163905
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
477367
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
163906
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
477372
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
163907
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1657212
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163908
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1147228
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
163909
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2197873
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
163910
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2197877
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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