Displaying 125661-125670 of 1611142 results.
ID:
125661
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
858804
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125662
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
794641
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125663
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
902624
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125664
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
902626
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125665
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
617768
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125666
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1790892
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125667
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1790886
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125668
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1790890
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125669
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
2384465
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
5
Qty Limit Days:
28
ID:
125670
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1670324
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
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