Displaying 165401-165410 of 1611142 results.
ID:
165401
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2199316
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165402
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2099323
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165403
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
206883
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165404
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2473107
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165405
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
206902
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165406
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
483450
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
165407
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
483438
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
165408
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
483440
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
165409
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
483444
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
165410
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2178403
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
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