Displaying 136201-136210 of 1611142 results.
ID:
136201
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
2058906
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136202
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
2049133
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136203
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
2049121
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136204
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1365979
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136205
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1855072
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
136206
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1986331
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136207
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1918230
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136208
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
2054269
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
136209
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
432400
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
136210
Formulary ID:
00021056
Formulary Version:
15
Contract Year:
2021
RXCUI:
1940654
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
136201136202136203136204136205136206136207136208136209136210