Displaying 131771-131780 of 1611142 results.
ID:
131771
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
313919
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
131772
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1797867
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131773
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
860107
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131774
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
904481
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131775
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
260218
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131776
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
205324
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
131777
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
617312
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131778
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
617310
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131779
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
617311
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131780
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
310818
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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