Displaying 137771-137780 of 1611142 results.
ID:
137771
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
855633
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137772
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1607784
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137773
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199245
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
137774
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199246
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
137775
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199247
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137776
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
314231
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137777
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312961
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137778
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198211
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
137779
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
200060
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137780
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
317573
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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