Displaying 103401-103410 of 1611142 results.
ID:
103401
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1870952
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103402
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1870960
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103403
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1870968
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
28
ID:
103404
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1304985
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
103405
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1811182
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
103406
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649405
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103407
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
852920
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103408
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313096
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103409
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198224
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103410
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
318179
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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