Displaying 126501-126510 of 1611142 results.
ID:
126501
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1595473
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126502
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1595478
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126503
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1595292
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126504
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1995479
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126505
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1595457
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126506
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
153579
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126507
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
153580
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126508
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
402092
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
126509
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
904170
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126510
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1859000
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
30
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