Displaying 128231-128240 of 1611142 results.
ID:
128231
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
904158
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128232
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
309370
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128233
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
103457
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128234
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197407
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128235
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
310364
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128236
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
238920
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128237
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
204135
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128238
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1370754
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128239
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1370750
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128240
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
203088
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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