Displaying 39021-39030 of 1611142 results.
ID:
39021
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
861659
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39022
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
861661
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39023
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
861663
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39024
Formulary ID:
00021011
Formulary Version:
14
Contract Year:
2021
RXCUI:
545278
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39025
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1551300
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
39026
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1551306
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
39027
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058877
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
39028
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1745108
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39029
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
2395779
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
39030
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058887
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
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