Displaying 104101-104110 of 1611142 results.
ID:
104101
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
348719
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104102
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110774
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
104103
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110777
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
104104
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110780
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
104105
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110783
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
104106
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110786
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
104107
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2183131
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104108
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
866907
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104109
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000133
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104110
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1873765
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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