Displaying 126901-126910 of 1611142 results.
ID:
126901
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
312036
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126902
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
856940
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
5400
Qty Limit Days:
30
ID:
126903
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
834137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126904
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
810002
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
126905
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
809990
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
126906
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
809994
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
126907
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
809998
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
126908
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
995156
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
ID:
126909
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197604
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
126910
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197606
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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