Displaying 129711-129720 of 1611142 results.
ID:
129711
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
897657
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1500
Qty Limit Days:
30
ID:
129712
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1049604
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3900
Qty Limit Days:
30
ID:
129713
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1874559
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
129714
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1874553
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
129715
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
900575
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
129716
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
977427
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129717
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
977434
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129718
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
977438
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129719
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
1304979
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
129720
Formulary ID:
00021054
Formulary Version:
15
Contract Year:
2021
RXCUI:
892625
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
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