Displaying 103701-103710 of 1611142 results.
ID:
103701
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311345
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103702
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198200
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103703
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
349514
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103704
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
351256
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103705
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
351257
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103706
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310261
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103707
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
308459
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103708
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
141963
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103709
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198317
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
103710
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198318
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
103701103702103703103704103705103706103707103708103709103710