Displaying 103691-103700 of 1611142 results.
ID:
103691
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197783
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103692
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313142
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103693
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312347
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103694
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198108
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103695
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1048450
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103696
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1020065
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
103697
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1048445
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103698
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
855626
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103699
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
855194
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103700
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1607617
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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