Displaying 128431-128440 of 1611142 results.
ID:
128431
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
731229
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128432
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
727542
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128433
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
993456
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
180
ID:
128434
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1046402
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128435
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1649491
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128436
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1649495
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128437
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2168596
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
450
Qty Limit Days:
30
ID:
128438
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2045638
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
128439
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2120195
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
30
ID:
128440
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1991509
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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