Displaying 137691-137700 of 1611142 results.
ID:
137691
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
209002
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137692
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
208420
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137693
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2055676
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137694
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2055672
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137695
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1010603
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
137696
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1307058
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137697
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1010606
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
137698
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1307063
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137699
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
314111
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137700
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
858798
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
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