Displaying 104331-104340 of 1611142 results.
ID:
104331
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310274
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104332
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313570
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
40
Qty Limit Days:
30
ID:
104333
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313571
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
80
Qty Limit Days:
30
ID:
104334
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
309049
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104335
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
309048
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104336
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
105171
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104337
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
995599
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104338
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
995607
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104339
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
307650
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104340
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
616402
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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