Displaying 104441-104450 of 1611142 results.
ID:
104441
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
845488
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104442
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
861736
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104443
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
861740
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104444
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
312817
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104445
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
577315
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104446
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
577317
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104447
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
836395
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
104448
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
833234
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104449
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
349253
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104450
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
656659
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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