Displaying 104091-104100 of 1611142 results.
ID:
104091
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312085
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104092
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
308429
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104093
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
283523
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2160
Qty Limit Days:
30
ID:
104094
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197745
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104095
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197746
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104096
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198358
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104097
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099569
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104098
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1244214
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104099
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197312
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104100
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
485496
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
900
Qty Limit Days:
30
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