Displaying 131911-131920 of 1611142 results.
ID:
131911
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
314208
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131912
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
312847
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131913
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
205284
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131914
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
205285
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
131915
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
643019
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
131916
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
643022
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
131917
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
349401
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131918
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
349405
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
131919
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
205322
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
131920
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
205323
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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