Displaying 165531-165540 of 1611142 results.
ID:
165531
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1992428
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165532
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
213282
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165533
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
213283
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165534
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
213284
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165535
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
859865
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165536
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
352297
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
165537
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
731328
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
165538
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
404460
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165539
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1593140
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165540
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1243848
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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