Displaying 102851-102860 of 1611142 results.
ID:
102851
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2381144
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
102852
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
465355
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
102853
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
979099
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
102854
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
967023
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
102855
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
967012
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
102856
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198332
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
102857
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
856987
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
102858
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
856992
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
102859
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197702
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
102860
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049615
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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