Displaying 138251-138260 of 1611142 results.
ID:
138251
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1246321
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
138252
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
865208
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138253
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
865212
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138254
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
865216
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138255
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
723827
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1800
Qty Limit Days:
30
ID:
138256
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
729201
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138257
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
729203
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
138258
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1796079
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138259
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1796083
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138260
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1433879
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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