Displaying 130781-130790 of 1611142 results.
ID:
130781
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1487086
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130782
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1539953
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130783
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1539955
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130784
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1605086
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130785
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
904419
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
130786
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
866436
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130787
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
855633
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130788
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1607784
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130789
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
199245
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
130790
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
199246
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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