Displaying 136001-136010 of 1611142 results.
ID:
136001
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
656659
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
136002
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
905158
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136003
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
199376
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136004
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
199381
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136005
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
898490
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136006
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
686429
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
136007
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
314142
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
136008
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
311919
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
136009
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1988308
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136010
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1988311
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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