Displaying 171901-171910 of 1611142 results.
ID:
171901
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
308136
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
171902
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
197361
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
171903
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
310432
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
270
Qty Limit Days:
30
ID:
171904
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
311880
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
171905
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
317174
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
171906
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
312745
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
171907
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
616483
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
171908
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
312743
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
171909
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
637173
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
171910
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
312840
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
36
Qty Limit Days:
28
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