Displaying 139831-139840 of 1611142 results.
ID:
139831
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
310005
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139832
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1099681
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139833
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
197682
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139834
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
866910
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139835
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
308867
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139836
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
198037
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139837
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1092357
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
139838
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1798370
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139839
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
1798375
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
139840
Formulary ID:
00021057
Formulary Version:
16
Contract Year:
2021
RXCUI:
200132
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
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