Displaying 130051-130060 of 1611142 results.
ID:
130051
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
859835
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130052
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
905273
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130053
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1099687
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130054
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
312036
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130055
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
856940
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
5400
Qty Limit Days:
30
ID:
130056
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
834137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130057
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
810002
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
130058
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
809990
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
130059
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
809994
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
130060
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
809998
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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