Displaying 137001-137010 of 1611142 results.
ID:
137001
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
898372
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137002
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
995278
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137003
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
995253
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137004
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198228
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137005
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
852913
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137006
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
993536
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137007
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
852877
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137008
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197979
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137009
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197978
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137010
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1246306
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
10
Qty Limit Days:
30
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