Displaying 128791-128800 of 1611142 results.
ID:
128791
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
861430
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128792
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197939
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128793
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197940
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128794
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
886662
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128795
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
886666
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128796
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
886671
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128797
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
686400
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128798
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1190572
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128799
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
835829
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128800
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
860975
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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