Displaying 127021-127030 of 1611142 results.
ID:
127021
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
207273
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
127022
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1437709
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
127023
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2001321
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
127024
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1091843
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
127025
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
402091
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
127026
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1986819
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
127027
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2289424
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
127028
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2289428
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
127029
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1942485
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
127030
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1942489
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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