Displaying 139341-139350 of 1611142 results.
ID:
139341
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
309078
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139342
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198352
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
139343
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
200031
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139344
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
200033
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139345
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
315223
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
139346
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
313161
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
139347
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
313160
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
139348
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
854873
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139349
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310796
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139350
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310797
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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