Displaying 139491-139500 of 1611142 results.
ID:
139491
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
106351
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139492
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198241
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139493
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198242
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139494
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308136
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139495
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197361
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139496
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310432
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139497
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311880
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139498
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
317174
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
139499
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312745
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139500
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
616483
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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