Displaying 172241-172250 of 1611142 results.
ID:
172241
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
198037
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172242
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1092357
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172243
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665473
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172244
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798370
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
172245
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798375
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
172246
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
200132
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
172247
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
199149
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
172248
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
199150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
172249
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
311915
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172250
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
1867544
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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