Displaying 103201-103210 of 1611142 results.
ID:
103201
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
858074
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
103202
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
858051
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
103203
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
858057
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
103204
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
858055
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
103205
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
858053
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
103206
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2059017
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103207
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232084
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103208
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232088
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103209
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1114202
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103210
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1549683
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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