Displaying 104521-104530 of 1611142 results.
ID:
104521
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
749157
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104522
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
748798
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104523
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1989507
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104524
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1053697
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104525
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
197849
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104526
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876920
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104527
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876924
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104528
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876916
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104529
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1111642
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104530
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1487363
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
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