Displaying 139301-139310 of 1611142 results.
ID:
139301
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
259081
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139302
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
835603
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
139303
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
283536
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139304
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199387
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139305
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312085
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139306
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308429
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139307
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
283523
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139308
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198358
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139309
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1099569
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139310
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1244214
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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