Displaying 133401-133410 of 1611142 results.
ID:
133401
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
800812
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133402
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1189640
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133403
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
800933
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133404
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
207273
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133405
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1437709
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133406
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
2001321
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
133407
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1091843
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
133408
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
402091
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
133409
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1986819
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
133410
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
2289424
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
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