Displaying 131301-131310 of 1611142 results.
ID:
131301
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1439903
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131302
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
2105657
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
131303
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
2105645
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
131304
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
2105653
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
600
Qty Limit Days:
30
ID:
131305
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
2180336
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
131306
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
615979
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131307
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
402252
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131308
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
207059
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
15
Qty Limit Days:
30
ID:
131309
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
211140
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131310
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
706831
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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