Displaying 213301-213310 of 1611142 results.
ID:
213301
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1487361
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
ID:
213302
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
351137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213303
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
351136
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213304
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1855389
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213305
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
728550
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
28
ID:
213306
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
199689
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213307
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
603208
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
213308
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
603203
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
213309
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
603206
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
213310
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
748961
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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