Displaying 104121-104130 of 1611142 results.
ID:
104121
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1925264
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
56
ID:
104122
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2049343
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
365
ID:
104123
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312941
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104124
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312938
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104125
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
308194
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104126
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
308182
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104127
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
283406
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104128
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
283407
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104129
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
283485
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104130
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
756209
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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