Displaying 177001-177010 of 1611142 results.
ID:
177001
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
199689
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
177002
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
603208
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
177003
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
603203
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
177004
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
603206
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
177005
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
748961
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
177006
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
751901
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
177007
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
810096
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
177008
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
749761
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
177009
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
748868
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
177010
Formulary ID:
00021078
Formulary Version:
13
Contract Year:
2021
RXCUI:
759743
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
177001177002177003177004177005177006177007177008177009177010