Displaying 125041-125050 of 1611142 results.
ID:
125041
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1373335
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125042
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1373337
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125043
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
312084
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125044
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
198051
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125045
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
312077
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125046
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313412
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125047
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313413
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125048
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
314286
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125049
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313776
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125050
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313777
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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