Displaying 139131-139140 of 1611142 results.
ID:
139131
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
104884
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139132
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
861430
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139133
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197939
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139134
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197940
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139135
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
886662
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139136
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
886666
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139137
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
886671
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139138
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
686400
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139139
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1190572
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139140
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
476345
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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