Displaying 125741-125750 of 1611142 results.
ID:
125741
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313222
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125742
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
309076
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125743
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
309078
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125744
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
198352
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
125745
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
200031
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125746
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
200033
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125747
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
315223
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
125748
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313161
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
125749
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313160
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
125750
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
854873
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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