Displaying 104751-104760 of 1611142 results.
ID:
104751
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2286261
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104752
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2472789
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104753
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
311040
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
40
Qty Limit Days:
28
ID:
104754
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653196
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
28
ID:
104755
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653202
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
28
ID:
104756
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
351297
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
40
Qty Limit Days:
28
ID:
104757
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
847191
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
28
ID:
104758
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2478450
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104759
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
2369403
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104760
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1594673
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
104751104752104753104754104755104756104757104758104759104760