Displaying 103901-103910 of 1611142 results.
ID:
103901
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
283317
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103902
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
477130
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103903
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
849389
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103904
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313407
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103905
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313408
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103906
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1536490
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103907
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310878
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103908
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049696
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
103909
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311982
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103910
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
104884
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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