Displaying 133701-133710 of 1611142 results.
ID:
133701
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
865123
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133702
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
860918
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133703
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
859841
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133704
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
313159
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
133705
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
197516
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133706
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
197517
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133707
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
996740
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
133708
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
311369
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
320
Qty Limit Days:
30
ID:
133709
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1482908
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
133710
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
310497
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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