Displaying 125301-125310 of 1611142 results.
ID:
125301
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313142
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125302
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
312347
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125303
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1048450
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125304
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1048445
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125305
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
855626
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125306
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1607617
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125307
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
311345
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125308
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
198200
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125309
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
349514
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125310
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
351256
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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