Displaying 104411-104420 of 1611142 results.
ID:
104411
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
314077
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104412
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
205326
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104413
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
646456
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104414
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1487251
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
104415
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
848768
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
104416
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1738511
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104417
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
205316
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104418
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
205315
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104419
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313583
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104420
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
313585
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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