Displaying 139261-139270 of 1611142 results.
ID:
139261
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
902624
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139262
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
902626
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139263
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
617768
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139264
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1790892
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139265
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1790886
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139266
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1790890
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139267
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
2384465
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
5
Qty Limit Days:
28
ID:
139268
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1670324
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
139269
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1670322
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
139270
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1600774
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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