Displaying 128141-128150 of 1611142 results.
ID:
128141
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2106075
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128142
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2058950
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128143
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2058946
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128144
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1722376
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
128145
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2100099
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
128146
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2100100
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
128147
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128148
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128149
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
ID:
128150
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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