Displaying 142501-142510 of 1611142 results.
ID:
142501
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
903456
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142502
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
903697
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142503
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
903703
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142504
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
313195
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142505
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
198240
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142506
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
2106648
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
130
Qty Limit Days:
31
ID:
142507
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
748865
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142508
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
749848
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142509
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
1995136
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
403
Qty Limit Days:
31
ID:
142510
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
753544
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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