Displaying 133001-133010 of 1611142 results.
ID:
133001
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1488619
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133002
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1488617
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133003
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1921468
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133004
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
152971
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
ID:
133005
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1873087
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133006
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1940709
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
84
Qty Limit Days:
28
ID:
133007
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
835896
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133008
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
835835
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133009
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1115468
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133010
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1926069
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
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