Displaying 165431-165440 of 1611142 results.
ID:
165431
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
966207
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165432
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1665906
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
165433
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1665900
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
165434
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1801322
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
165435
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2262446
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
165436
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2123034
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
165437
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
2274390
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
165438
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1799212
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
165439
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1659183
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
165440
Formulary ID:
00021065
Formulary Version:
15
Contract Year:
2021
RXCUI:
1659161
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
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