Displaying 39011-39020 of 1611142 results.
ID:
39011
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
105553
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39012
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
105590
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39013
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364498
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
45
Qty Limit Days:
30
ID:
39014
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364490
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
39015
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364494
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
39016
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
1648772
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
39017
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
2046597
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
228
Qty Limit Days:
14
ID:
39018
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
1989117
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
39019
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178792
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
39020
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
644304
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
39011390123901339014390153901639017390183901939020