Displaying 139811-139820 of 1611142 results.
ID:
139811
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
483446
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
139812
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
312515
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139813
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310155
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139814
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
315090
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139815
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310157
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139816
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1795598
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139817
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1366192
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
ID:
139818
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1796922
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139819
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
311913
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139820
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1744001
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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