Displaying 43201-43210 of 1611142 results.
ID:
43201
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
313159
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
30
ID:
43202
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
197516
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
43203
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
197517
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
43204
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
996740
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
43205
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
311369
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
ID:
43206
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
1482908
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
43207
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806187
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
43208
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806189
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
43209
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806191
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
43210
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806193
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
43201432024320343204432054320643207432084320943210