Displaying 131261-131270 of 1611142 results.
ID:
131261
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
198369
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131262
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
198370
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131263
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1659803
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131264
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1242819
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
30
ID:
131265
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1242815
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
131266
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
616749
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
131267
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
728231
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
131268
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1657212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131269
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1147228
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
131270
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
2197873
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
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