Displaying 104031-104040 of 1611142 results.
ID:
104031
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198252
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104032
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649593
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
104033
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1546189
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
104034
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2261794
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104035
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1040058
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104036
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
858804
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104037
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
794641
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104038
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
902624
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104039
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
902626
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104040
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
617768
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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