Displaying 125801-125810 of 1611142 results.
ID:
125801
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
863669
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125802
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
313581
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125803
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
402246
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125804
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
402247
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125805
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
664741
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125806
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
833528
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125807
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
722134
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125808
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
722137
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125809
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
722126
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
125810
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
722131
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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