Displaying 104161-104170 of 1611142 results.
ID:
104161
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
854988
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104162
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
854925
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104163
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
857166
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104164
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
857174
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104165
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
904431
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
104166
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312087
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104167
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198334
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104168
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198335
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104169
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
433798
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104170
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
433800
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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