Displaying 125361-125370 of 1611142 results.
ID:
125361
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
284008
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125362
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313919
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
125363
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1797865
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125364
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1797867
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125365
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1797847
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125366
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
860107
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125367
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
904481
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125368
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
260218
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125369
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
205324
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125370
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
617312
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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