Displaying 139501-139510 of 1611142 results.
ID:
139501
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312743
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
139502
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
637173
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139503
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312840
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
139504
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
314209
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
139505
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
199206
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139506
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197805
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139507
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197806
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139508
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197807
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139509
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311347
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139510
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311204
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
139501139502139503139504139505139506139507139508139509139510