Displaying 166901-166910 of 1611142 results.
ID:
166901
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1361574
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166902
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
351246
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166903
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
200193
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
28
ID:
166904
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
200194
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
28
ID:
166905
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
317094
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166906
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
349435
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166907
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
349434
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166908
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1013930
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166909
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
310289
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166910
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
1043025
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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