Displaying 139361-139370 of 1611142 results.
ID:
139361
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
314108
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139362
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311290
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139363
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
854984
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139364
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
854988
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139365
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
854925
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139366
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
857166
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
139367
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
857174
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
139368
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
904431
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
139369
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312087
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139370
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198334
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
139361139362139363139364139365139366139367139368139369139370