Displaying 138701-138710 of 1611142 results.
ID:
138701
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197700
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138702
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
596926
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
138703
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
596930
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138704
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
596934
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138705
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308192
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138706
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
834061
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138707
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
834102
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138708
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310436
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138709
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310437
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138710
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
579148
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
138701138702138703138704138705138706138707138708138709138710