Displaying 126201-126210 of 1611142 results.
ID:
126201
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1731020
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126202
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
403930
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126203
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
1944656
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126204
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
197843
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126205
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
197844
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126206
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
197845
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126207
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
728113
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
126208
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
483442
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
126209
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
483448
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
126210
Formulary ID:
00021051
Formulary Version:
15
Contract Year:
2021
RXCUI:
483446
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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