Displaying 39131-39140 of 1611142 results.
ID:
39131
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
762852
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39132
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
762859
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39133
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
762868
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39134
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
762897
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39135
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1009341
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
25
ID:
39136
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1595462
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39137
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1595473
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39138
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1595478
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39139
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1595292
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
39140
Formulary ID:
00021014
Formulary Version:
14
Contract Year:
2021
RXCUI:
1995479
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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