Displaying 104201-104210 of 1611142 results.
ID:
104201
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
402246
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104202
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
402247
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104203
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
664741
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104204
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
833528
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104205
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
722134
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104206
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
722137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104207
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
722126
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104208
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
722131
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104209
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
860715
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104210
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
860695
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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