Displaying 128041-128050 of 1611142 results.
ID:
128041
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1870207
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
128042
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1374574
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
128043
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2001430
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128044
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2003255
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128045
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2043464
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128046
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1246321
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
128047
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
865208
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128048
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
865212
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128049
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
865216
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128050
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
723827
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1800
Qty Limit Days:
30
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