Displaying 136521-136530 of 1611142 results.
ID:
136521
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
351266
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
136522
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
351267
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
136523
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
905172
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136524
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
905168
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136525
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
892589
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3000
Qty Limit Days:
30
ID:
136526
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
894780
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1500
Qty Limit Days:
30
ID:
136527
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
997170
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
136528
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
997287
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
136529
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
997296
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
136530
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310792
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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