Displaying 131501-131510 of 1611142 results.
ID:
131501
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
197512
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131502
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1373333
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131503
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1373335
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131504
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1373337
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131505
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
312084
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131506
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
198051
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131507
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
312077
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131508
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
313412
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131509
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
313413
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131510
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
314286
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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