Displaying 137451-137460 of 1611142 results.
ID:
137451
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
991086
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137452
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
314006
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
137453
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
315107
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137454
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310489
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
137455
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
250344
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137456
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
722122
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137457
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
722116
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137458
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198250
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137459
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197502
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137460
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
863559
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1080
Qty Limit Days:
30
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