Displaying 104531-104540 of 1611142 results.
ID:
104531
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
308725
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
420
Qty Limit Days:
30
ID:
104532
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
855657
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104533
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812011
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104534
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812013
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104535
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
562806
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
30
ID:
104536
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
825130
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104537
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
260260
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104538
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1370758
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104539
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311382
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104540
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
861668
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
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