Displaying 132501-132510 of 1611142 results.
ID:
132501
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
602393
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
132502
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
432402
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
132503
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
403875
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
132504
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
310430
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
132505
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
310459
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
132506
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
828320
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
132507
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
314285
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
132508
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
310431
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
132509
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1731020
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
132510
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
403930
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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