Displaying 169391-169400 of 1611142 results.
ID:
169391
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1299909
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
169392
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
197507
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
169393
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
359493
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
28
ID:
169394
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
359494
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
28
ID:
169395
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362706
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
169396
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362712
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
169397
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362720
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
169398
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
197975
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
169399
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
308865
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
169400
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1303736
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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