Displaying 104281-104290 of 1611142 results.
ID:
104281
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
404419
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104282
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
106351
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104283
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198241
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104284
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
198242
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104285
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
308136
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104286
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197361
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104287
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310432
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
270
Qty Limit Days:
30
ID:
104288
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311880
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104289
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
317174
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104290
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312745
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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