Displaying 128521-128530 of 1611142 results.
ID:
128521
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
309888
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128522
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
309889
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128523
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
213360
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128524
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
404449
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128525
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
700418
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128526
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
404450
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128527
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1242233
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128528
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
616116
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128529
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
616114
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128530
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
643714
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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