Displaying 172201-172210 of 1611142 results.
ID:
172201
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
828320
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172202
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
314285
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172203
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
198006
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172204
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
198007
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172205
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
198008
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172206
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
200311
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172207
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
310431
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
172208
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
702306
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172209
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1731020
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172210
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
751563
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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