Displaying 125761-125770 of 1611142 results.
ID:
125761
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
979480
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125762
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
248109
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125763
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
314108
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125764
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
311290
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125765
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
854984
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125766
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
854988
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125767
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
854925
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125768
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
857166
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
125769
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
857174
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
125770
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
904431
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
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