Displaying 170751-170760 of 1611142 results.
ID:
170751
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1251903
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
170752
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
721787
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
170753
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
860215
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
170754
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
860221
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
170755
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
198056
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
170756
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
351276
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
170757
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
349194
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
170758
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
349195
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
170759
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
349198
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
170760
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
403825
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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