Displaying 104481-104490 of 1611142 results.
ID:
104481
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197891
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104482
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197892
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104483
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
151029
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104484
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311265
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104485
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311264
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104486
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
897649
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104487
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
349594
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104488
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
349595
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104489
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
608143
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104490
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
608139
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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