Displaying 103031-103040 of 1611142 results.
ID:
103031
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115698
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
180
ID:
103032
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1308569
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103033
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
351209
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103034
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310362
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103035
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197623
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103036
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055650
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
103037
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099808
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103038
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1484296
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103039
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1190919
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103040
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1244205
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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