Displaying 139101-139110 of 1611142 results.
ID:
139101
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
897584
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139102
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
897590
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139103
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
897596
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139104
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
317769
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139105
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
314208
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139106
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312847
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139107
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
205284
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139108
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
205285
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139109
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
643019
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
139110
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
643022
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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