Displaying 104401-104410 of 1611142 results.
ID:
104401
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1543553
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104402
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1422081
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104403
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1427300
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104404
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
748800
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104405
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1599949
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
104406
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
848180
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104407
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
141850
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104408
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197573
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104409
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2123072
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
17
Qty Limit Days:
30
ID:
104410
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
314076
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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