Displaying 103171-103180 of 1611142 results.
ID:
103171
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103172
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103173
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
ID:
103174
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103175
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923432
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103176
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
578018
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103177
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
477391
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103178
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197877
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103179
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1010739
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103180
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
391937
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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