Displaying 129401-129410 of 1611142 results.
ID:
129401
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
310003
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129402
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
310004
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129403
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
310005
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129404
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1099681
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129405
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197682
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129406
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
308867
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129407
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
198037
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129408
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1092357
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129409
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
200132
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
129410
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
199149
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
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