Displaying 125701-125710 of 1611142 results.
ID:
125701
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
259081
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125702
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
835603
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
125703
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
283536
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125704
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
199387
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125705
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
312085
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125706
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
308429
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125707
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
283523
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125708
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
197745
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125709
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
197746
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125710
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
198358
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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