Displaying 103001-103010 of 1611142 results.
ID:
103001
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1799654
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103002
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
105292
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103003
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1943345
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103004
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2053458
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103005
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
199592
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
103006
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
483090
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103007
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
476399
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103008
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
476515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103009
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
805464
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
103010
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1659927
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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