Displaying 135051-135060 of 1611142 results.
ID:
135051
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
579148
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
135052
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
104894
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135053
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
861132
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135054
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
310352
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135055
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
310353
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135056
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
200257
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
960
Qty Limit Days:
30
ID:
135057
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
200256
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
ID:
135058
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
200258
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
135059
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
313582
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135060
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
313584
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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