Displaying 103751-103760 of 1611142 results.
ID:
103751
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
213291
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103752
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1111339
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103753
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
860805
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103754
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
308739
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
25
ID:
103755
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1111343
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103756
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
284008
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
25
ID:
103757
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313919
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
103758
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1797865
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
34
Qty Limit Days:
28
ID:
103759
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1797867
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
25
ID:
103760
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
860107
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
10
Qty Limit Days:
25
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