Displaying 139731-139740 of 1611142 results.
ID:
139731
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1989507
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139732
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1876920
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
139733
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1876924
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
139734
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1876916
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
139735
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308725
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139736
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
855657
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139737
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1812011
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139738
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1812013
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
139739
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
562806
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
30
ID:
139740
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
825130
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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