Displaying 135301-135310 of 1611142 results.
ID:
135301
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
617311
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
135302
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
310818
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135303
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
259255
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
135304
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
905028
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
30
ID:
135305
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
905024
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
135306
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
577208
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
135307
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
205328
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135308
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
314155
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
135309
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
351107
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
135310
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
859193
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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