Displaying 125261-125270 of 1611142 results.
ID:
125261
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
205918
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125262
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
205922
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125263
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
205924
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125264
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1721690
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125265
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
212219
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125266
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
213475
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125267
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
794610
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125268
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
831870
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125269
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
850457
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
125270
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1236632
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
400
Qty Limit Days:
30
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