Displaying 135701-135710 of 1611142 results.
ID:
135701
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
248109
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135702
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
314108
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135703
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
311290
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
135704
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
854984
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
135705
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
854988
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
135706
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
854925
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
135707
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
857166
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
135708
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
857174
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
135709
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
904431
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
135710
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
312087
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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