Displaying 165901-165910 of 1611142 results.
ID:
165901
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
866090
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165902
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
643066
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165903
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1006801
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165904
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
996921
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165905
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
721773
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165906
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
476179
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165907
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
476177
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165908
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
199703
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165909
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1359129
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
165910
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
485440
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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