Displaying 104001-104010 of 1611142 results.
ID:
104001
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1795609
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104002
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1795477
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104003
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
581531
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104004
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2371050
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
104005
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2371054
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
104006
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2371058
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
104007
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2371062
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
104008
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2371066
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
104009
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1482513
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104010
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1482517
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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