Displaying 134281-134290 of 1611142 results.
ID:
134281
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
884185
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134282
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
884189
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134283
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1099625
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134284
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
996571
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
134285
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
996561
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
134286
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
854916
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
134287
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
854919
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
134288
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
854908
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
134289
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
201708
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134290
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
248420
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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