Displaying 103011-103020 of 1611142 results.
ID:
103011
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2056748
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
25
ID:
103012
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2046585
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
103013
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
403878
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
103014
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1098143
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103015
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200174
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103016
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200177
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103017
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200180
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103018
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200183
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103019
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2167575
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103020
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2167563
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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