Displaying 104141-104150 of 1611142 results.
ID:
104141
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
200033
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104142
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
315223
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
30
ID:
104143
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313161
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
30
ID:
104144
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313160
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
9
Qty Limit Days:
30
ID:
104145
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
854873
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104146
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310796
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104147
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310797
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104148
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310809
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104149
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198052
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104150
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312086
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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