Displaying 126831-126840 of 1611142 results.
ID:
126831
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
429212
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126832
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
309374
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126833
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1299917
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126834
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
995218
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126835
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
866090
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126836
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
643066
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
126837
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1652084
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126838
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1006801
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
126839
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
996921
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
126840
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
721773
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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