Displaying 136901-136910 of 1611142 results.
ID:
136901
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
834127
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136902
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
141935
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136903
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
849385
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136904
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
861848
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136905
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
859835
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136906
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
905273
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136907
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1099687
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136908
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312036
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
136909
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
856940
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
5400
Qty Limit Days:
30
ID:
136910
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
834137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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