Displaying 126601-126610 of 1611142 results.
ID:
126601
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
198146
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126602
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
207100
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126603
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
208821
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126604
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
351875
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126605
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1307630
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
126606
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1307635
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
126607
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1243010
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
126608
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1243014
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
126609
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1601394
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
126610
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1601386
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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