Displaying 104571-104580 of 1611142 results.
ID:
104571
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
199672
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104572
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
252559
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104573
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
239238
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104574
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
602393
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104575
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
432402
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104576
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
477560
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104577
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
477562
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104578
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373497
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104579
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
403875
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104580
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
310430
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
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