Displaying 139531-139540 of 1611142 results.
ID:
139531
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311288
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139532
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311289
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139533
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
387003
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139534
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
807832
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139535
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
846378
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139536
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
309112
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139537
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
309114
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139538
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
828373
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139539
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310274
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139540
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
313570
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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