Displaying 138711-138720 of 1611142 results.
ID:
138711
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
104894
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138712
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
861132
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138713
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310352
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138714
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310353
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138715
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
200257
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
960
Qty Limit Days:
30
ID:
138716
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
200256
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
ID:
138717
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
200258
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
138718
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
313582
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138719
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
313584
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138720
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
314277
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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