Displaying 138111-138120 of 1611142 results.
ID:
138111
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
597987
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138112
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
597977
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138113
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
597971
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138114
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
403908
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138115
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198038
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138116
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198039
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138117
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198040
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138118
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1010600
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
138119
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1307056
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138120
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1010604
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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