Displaying 104251-104260 of 1611142 results.
ID:
104251
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
861654
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104252
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2123076
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
36
Qty Limit Days:
30
ID:
104253
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
349591
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104254
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
349592
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104255
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
349593
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104256
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1011736
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104257
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1011739
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104258
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
388311
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104259
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
200133
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104260
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
200131
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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