Displaying 218801-218810 of 1611142 results.
ID:
218801
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
197361
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218802
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
310432
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
270
Qty Limit Days:
30
ID:
218803
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
311880
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218804
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
317174
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
218805
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
312745
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
218806
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
616483
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
218807
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
312743
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
218808
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
312840
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
36
Qty Limit Days:
28
ID:
218809
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
314209
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
36
Qty Limit Days:
28
ID:
218810
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
199206
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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