Displaying 103921-103930 of 1611142 results.
ID:
103921
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
476349
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103922
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
476350
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103923
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
476351
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
103924
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
835829
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103925
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
860975
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
103926
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
860981
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
103927
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312136
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103928
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103929
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1299911
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
103930
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
855861
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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