Displaying 137491-137500 of 1611142 results.
ID:
137491
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197364
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137492
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197383
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137493
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197382
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137494
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
805515
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
380
Qty Limit Days:
30
ID:
137495
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
603378
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
137496
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1190225
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
20
ID:
137497
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
580261
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137498
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
836368
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137499
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1552004
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
137500
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1430453
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
137491137492137493137494137495137496137497137498137499137500