Displaying 128921-128930 of 1611142 results.
ID:
128921
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1116758
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128922
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
543492
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128923
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1440936
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128924
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
309077
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128925
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
313428
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128926
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
242680
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
960
Qty Limit Days:
30
ID:
128927
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
205292
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
128928
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
205290
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
128929
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
315134
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128930
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1992303
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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