Displaying 172131-172140 of 1611142 results.
ID:
172131
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
835726
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172132
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
349373
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172133
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
857216
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172134
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
857224
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172135
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
861512
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
125
Qty Limit Days:
28
ID:
172136
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
197572
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172137
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
314266
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
30
ID:
172138
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
749784
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172139
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
644088
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172140
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
866905
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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