Displaying 128801-128810 of 1611142 results.
ID:
128801
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
860981
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128802
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
312136
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128803
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
312137
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128804
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1299911
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128805
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
855861
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128806
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197890
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128807
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
855873
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128808
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
308989
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128809
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
308988
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128810
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197443
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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