Displaying 138731-138740 of 1611142 results.
ID:
138731
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
205329
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
138732
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
205330
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
138733
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
205331
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
138734
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
999967
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138735
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
999996
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138736
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
999986
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138737
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1000001
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138738
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
999991
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138739
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
984082
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138740
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1654079
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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