Displaying 138241-138250 of 1611142 results.
ID:
138241
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1658241
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
1
ID:
138242
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1939299
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138243
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1939348
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138244
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
577324
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138245
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
727316
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
138246
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1870207
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
138247
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1374574
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
138248
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2001430
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138249
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2003255
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138250
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2043464
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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