Displaying 142801-142810 of 1611142 results.
ID:
142801
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
798479
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142802
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
1300378
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142803
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
1300370
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142804
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
805579
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142805
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
901518
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142806
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
830463
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142807
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
1601407
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
142808
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
809159
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
142809
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
802652
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
7
Qty Limit Days:
28
ID:
142810
Formulary ID:
00021058
Formulary Version:
15
Contract Year:
2021
RXCUI:
1653225
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
7
Qty Limit Days:
28
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