Displaying 122501-122510 of 1611142 results.
ID:
122501
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
311919
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
122502
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
1988308
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
122503
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
1988311
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
122504
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
1988316
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
122505
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
1988319
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
122506
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
1988324
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
122507
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
1988330
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
122508
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
1649401
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
122509
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
2054979
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
122510
Formulary ID:
00021049
Formulary Version:
16
Contract Year:
2021
RXCUI:
2054983
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
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