Displaying 137061-137070 of 1611142 results.
ID:
137061
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1189640
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137062
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
800933
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137063
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
207273
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137064
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1437709
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137065
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2001321
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137066
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1091843
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137067
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
402091
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137068
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1986819
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137069
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2289424
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
137070
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2289428
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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