Displaying 104721-104730 of 1611142 results.
ID:
104721
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
483440
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104722
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
483444
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104723
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178403
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
ID:
104724
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178405
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
16
Qty Limit Days:
28
ID:
104725
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2382990
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
24
Qty Limit Days:
28
ID:
104726
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178407
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
32
Qty Limit Days:
28
ID:
104727
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178409
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
20
Qty Limit Days:
28
ID:
104728
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2382991
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
16
Qty Limit Days:
28
ID:
104729
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2382993
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
104730
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272630
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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