Displaying 125021-125030 of 1611142 results.
ID:
125021
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
283535
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125022
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
198222
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125023
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
198150
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125024
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
96304
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125025
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
998689
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125026
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
998685
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125027
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
206791
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
125028
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
580286
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
125029
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1313785
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125030
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
207588
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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