Displaying 124301-124310 of 1611142 results.
ID:
124301
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
861010
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
124302
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
861004
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
75
Qty Limit Days:
30
ID:
124303
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
861731
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
124304
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
562524
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
124305
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1652673
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
124306
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1649429
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
124307
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1650142
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
124308
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
353538
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
124309
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1723156
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
124310
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
897666
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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