Displaying 128301-128310 of 1611142 results.
ID:
128301
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
831533
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128302
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1359134
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128303
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
312138
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128304
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
312839
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
128305
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
312837
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
128306
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1359127
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128307
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1359124
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128308
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
403884
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128309
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
310599
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128310
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
856535
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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