Displaying 103371-103380 of 1611142 results.
ID:
103371
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313499
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103372
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313496
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103373
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1111110
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
20
Qty Limit Days:
10
ID:
103374
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2279847
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
10
ID:
103375
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1001690
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103376
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2465556
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103377
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
905394
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103378
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
404539
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103379
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115012
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
103380
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115013
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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