Displaying 128441-128450 of 1611142 results.
ID:
128441
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
858125
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128442
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
858127
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128443
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197699
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128444
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197700
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128445
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
596926
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
128446
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
596930
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128447
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
596934
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128448
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
308192
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128449
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
834061
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128450
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
834102
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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