Displaying 139111-139120 of 1611142 results.
ID:
139111
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
866482
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139112
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
866479
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139113
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
349401
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139114
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
349405
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139115
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
205322
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139116
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
205323
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139117
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
403853
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139118
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
403854
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139119
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
403855
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139120
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
859981
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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