Displaying 128201-128210 of 1611142 results.
ID:
128201
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1739788
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
600
Qty Limit Days:
30
ID:
128202
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1149617
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128203
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
213197
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128204
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
997010
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128205
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
866427
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128206
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
866412
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128207
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
866419
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128208
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1193341
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128209
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1193337
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128210
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1193345
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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