Displaying 128001-128010 of 1611142 results.
ID:
128001
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
805464
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
128002
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1659927
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128003
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
403878
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
128004
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2200174
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128005
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2200177
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128006
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2200180
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
128007
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2200183
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128008
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1648755
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128009
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
725021
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128010
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
725023
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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