Displaying 130761-130770 of 1611142 results.
ID:
130761
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
197985
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130762
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
197984
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130763
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
598006
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130764
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
197650
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130765
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
861601
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130766
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
861597
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
130767
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
615882
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130768
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
643070
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
130769
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
855926
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130770
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
855906
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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