Displaying 172301-172310 of 1611142 results.
ID:
172301
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2045958
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172302
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2059189
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
172303
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2265701
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
172304
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2283505
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
172305
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2283515
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
172306
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2283518
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
172307
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2283509
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
172308
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2283513
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
172309
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2283538
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
172310
Formulary ID:
00021071
Formulary Version:
14
Contract Year:
2021
RXCUI:
2283536
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
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