Displaying 138201-138210 of 1611142 results.
ID:
138201
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199592
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
138202
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
483090
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138203
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
476399
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138204
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
476515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138205
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
805464
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
138206
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1659927
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138207
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
403878
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
138208
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1098143
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138209
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2200174
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138210
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2200177
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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