Displaying 103791-103800 of 1611142 results.
ID:
103791
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
731571
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103792
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
476872
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103793
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049223
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
103794
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049227
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
103795
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049216
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
103796
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
854801
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103797
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313477
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103798
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
861200
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103799
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
861208
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103800
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000647
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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