Displaying 131401-131410 of 1611142 results.
ID:
131401
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
308973
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131402
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
858824
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131403
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
858828
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
131404
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
308976
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131405
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
310379
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131406
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
310380
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131407
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1313112
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131408
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
855671
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131409
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
311679
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131410
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
105583
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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