Displaying 104611-104620 of 1611142 results.
ID:
104611
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
866910
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104612
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
308867
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104613
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1092357
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104614
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665473
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104615
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798370
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104616
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798375
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104617
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
200132
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104618
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
199149
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104619
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
199150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104620
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311915
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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