Displaying 104701-104710 of 1611142 results.
ID:
104701
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999316
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104702
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058520
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
104703
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058525
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
104704
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
966607
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104705
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
208083
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104706
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2054275
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
14
Qty Limit Days:
28
ID:
104707
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2275613
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104708
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272118
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104709
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272122
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104710
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272126
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
104701104702104703104704104705104706104707104708104709104710