Displaying 104761-104770 of 1611142 results.
ID:
104761
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
905059
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
104762
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
905064
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
ID:
104763
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
905057
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
168
ID:
104764
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1251334
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104765
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1100070
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104766
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1487076
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
224
Qty Limit Days:
28
ID:
104767
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1368459
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104768
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
751970
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104769
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
836358
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
312
Qty Limit Days:
30
ID:
104770
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
1191250
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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