Displaying 137011-137020 of 1611142 results.
ID:
137011
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1246290
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
10
Qty Limit Days:
30
ID:
137012
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1666334
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137013
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1116639
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137014
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
859192
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137015
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1539762
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137016
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
991233
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137017
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308047
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
137018
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308048
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
137019
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197321
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
137020
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197322
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
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