Displaying 134041-134050 of 1611142 results.
ID:
134041
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
858798
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
134042
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
311725
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134043
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
311726
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134044
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
884386
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
134045
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
884385
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
134046
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
993770
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
390
Qty Limit Days:
30
ID:
134047
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
993890
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
390
Qty Limit Days:
30
ID:
134048
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
864718
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
134049
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
197593
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134050
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
199168
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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