Displaying 163921-163930 of 1611142 results.
ID:
163921
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1722376
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
163922
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2100099
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
163923
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2100100
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
163924
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2054310
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
163925
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2054313
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
163926
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2054316
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
163927
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2054318
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
163928
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163929
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
163930
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
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