Displaying 165711-165720 of 1611142 results.
ID:
165711
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
2168548
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165712
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
2058932
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
165713
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1148506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
165714
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1148502
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
165715
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
2168540
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165716
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
207088
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165717
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
855871
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165718
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1855527
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
180
ID:
165719
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921240
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
165720
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921245
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
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