Displaying 137701-137710 of 1611142 results.
ID:
137701
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311725
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137702
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311726
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137703
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
884386
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
137704
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
884385
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
137705
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
993770
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
390
Qty Limit Days:
30
ID:
137706
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
993890
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
390
Qty Limit Days:
30
ID:
137707
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
864718
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
137708
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197593
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137709
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199168
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137710
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312357
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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