Displaying 165761-165770 of 1611142 results.
ID:
165761
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1364114
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165762
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1364118
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165763
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1364122
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165764
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1603361
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
165765
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1603365
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
165766
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1603369
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
165767
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1656346
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
165768
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1425110
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
165769
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1425118
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
165770
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
867506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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