Displaying 104301-104310 of 1611142 results.
ID:
104301
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311204
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104302
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
898715
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
900
Qty Limit Days:
30
ID:
104303
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
282755
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104304
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
205304
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104305
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
205305
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104306
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
409823
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104307
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
892582
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
104308
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
892672
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104309
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923822
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104310
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923828
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
104301104302104303104304104305104306104307104308104309104310