Displaying 129691-129700 of 1611142 results.
ID:
129691
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
393245
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129692
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
885857
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129693
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
351265
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
129694
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
351266
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
129695
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
351267
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
129696
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
905172
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129697
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
905168
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129698
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
892589
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3000
Qty Limit Days:
30
ID:
129699
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
894780
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1500
Qty Limit Days:
30
ID:
129700
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
997170
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
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