Displaying 137721-137730 of 1611142 results.
ID:
137721
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
317110
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137722
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
402698
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137723
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
402696
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137724
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
402695
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137725
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
351249
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137726
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
858625
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137727
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
855182
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137728
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
855189
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137729
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
602964
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137730
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
402131
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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