Displaying 136861-136870 of 1611142 results.
ID:
136861
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
904467
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136862
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
904475
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136863
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1490065
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136864
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199058
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136865
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
596843
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
136866
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308868
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136867
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
403879
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
136868
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
476556
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
136869
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197535
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136870
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310295
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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