Displaying 134401-134410 of 1611142 results.
ID:
134401
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
848750
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
134402
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
848730
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
134403
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
848734
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
134404
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
848752
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134405
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1491624
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
134406
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
2468316
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
158
Qty Limit Days:
30
ID:
134407
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
2381144
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
134408
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
465355
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134409
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
979099
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
134410
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
967023
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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