Displaying 125901-125910 of 1611142 results.
ID:
125901
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
312743
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
125902
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
637173
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125903
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
312840
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
125904
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
314209
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
125905
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
199206
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125906
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
197805
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125907
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
197806
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125908
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
197807
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
125909
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
311347
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
125910
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
311204
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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