Displaying 136401-136410 of 1611142 results.
ID:
136401
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
213284
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136402
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
859865
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
136403
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
404460
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
136404
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1593140
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
1
ID:
136405
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1547575
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136406
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1547110
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136407
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1243848
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
136408
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1243843
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
136409
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1243833
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136410
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
665044
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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