Displaying 128551-128560 of 1611142 results.
ID:
128551
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
212219
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128552
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
213475
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128553
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
794610
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128554
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
831870
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128555
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
850457
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
128556
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1236632
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
400
Qty Limit Days:
30
ID:
128557
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1359271
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128558
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
758555
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128559
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1052660
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128560
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1250723
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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