Displaying 128121-128130 of 1611142 results.
ID:
128121
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
198372
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128122
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
198369
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128123
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
198370
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128124
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1659803
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128125
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1242819
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
30
ID:
128126
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1242815
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
128127
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
616749
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128128
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
728231
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128129
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
477367
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128130
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
477372
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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