Displaying 138021-138030 of 1611142 results.
ID:
138021
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1790175
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138022
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1790167
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138023
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1790171
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138024
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197703
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138025
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1300783
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
1
ID:
138026
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
831261
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138027
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
861025
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
765
Qty Limit Days:
30
ID:
138028
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
825005
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
138029
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
881341
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138030
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199690
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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