Displaying 128951-128960 of 1611142 results.
ID:
128951
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197745
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128952
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197746
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128953
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
198358
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128954
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1099569
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128955
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1244214
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128956
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
485496
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
750
Qty Limit Days:
30
ID:
128957
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
348719
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
128958
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
2183131
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
128959
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
825134
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
128960
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1801519
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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