Displaying 137821-137830 of 1611142 results.
ID:
137821
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
863619
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
137822
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
863628
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
137823
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
314080
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137824
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1190655
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137825
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
545236
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137826
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1724340
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137827
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312075
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137828
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308345
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137829
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197636
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137830
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
260243
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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