Displaying 125011-125020 of 1611142 results.
ID:
125011
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1369831
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125012
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1304985
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125013
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1811182
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125014
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1716215
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125015
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1716219
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125016
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1716223
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125017
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1649405
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125018
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
852920
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125019
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313096
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125020
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
198224
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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