Displaying 128011-128020 of 1611142 results.
ID:
128011
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
311995
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128012
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1648759
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128013
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
903847
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128014
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1307061
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128015
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1115698
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
780
Qty Limit Days:
30
ID:
128016
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1308569
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128017
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
351209
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128018
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
310362
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128019
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197623
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128020
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2055650
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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