Displaying 165601-165610 of 1611142 results.
ID:
165601
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1653579
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165602
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
198148
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165603
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1797833
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
165604
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1797844
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
165605
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
393245
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165606
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
885857
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165607
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
860901
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165608
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
351265
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165609
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
351266
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
165610
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
351267
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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