Displaying 133241-133250 of 1611142 results.
ID:
133241
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
313979
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133242
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
834127
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133243
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
141935
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133244
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
849385
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133245
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
861848
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133246
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
859835
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133247
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
905273
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133248
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1099687
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133249
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
312036
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133250
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
856940
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
5400
Qty Limit Days:
30
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