Displaying 104621-104630 of 1611142 results.
ID:
104621
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1725064
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
104622
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2001439
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104623
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1437713
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104624
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1918242
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104625
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862595
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104626
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921589
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104627
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862590
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104628
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1666545
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104629
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1666542
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104630
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
831246
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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