Displaying 138851-138860 of 1611142 results.
ID:
138851
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1721690
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138852
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
212219
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138853
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
213475
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
138854
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
794610
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138855
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
831870
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138856
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
850457
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
138857
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1236632
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
400
Qty Limit Days:
30
ID:
138858
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1359271
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
138859
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
758555
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
138860
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1052660
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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