Displaying 130951-130960 of 1611142 results.
ID:
130951
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
242438
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
130952
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
200094
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
130953
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
200095
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
130954
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
200096
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
130955
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
197311
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130956
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
197313
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130957
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
313566
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
130958
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
485434
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130959
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
485436
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
130960
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
859424
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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