Displaying 195251-195260 of 1611142 results.
ID:
195251
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
403922
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
195252
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
402109
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
195253
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
855875
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
195254
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
834235
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
195255
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
834241
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
195256
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
359144
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
195257
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
359145
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
195258
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
1000076
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
195259
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
1606347
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
195260
Formulary ID:
00021083
Formulary Version:
17
Contract Year:
2021
RXCUI:
1606349
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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