Displaying 133791-133800 of 1611142 results.
ID:
133791
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
861427
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133792
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
991086
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133793
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
314006
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
133794
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
315107
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
133795
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
310489
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
133796
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
250344
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133797
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
722122
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
133798
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
722116
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
133799
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
198250
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
133800
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
197502
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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