Displaying 137921-137930 of 1611142 results.
ID:
137921
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1013930
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137922
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310289
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137923
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1043025
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137924
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1043031
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137925
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1373016
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137926
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1372999
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137927
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
855858
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
137928
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
313306
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137929
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
348472
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
137930
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
282401
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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