Displaying 104791-104800 of 1611142 results.
ID:
104791
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
861663
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104792
Formulary ID:
00021039
Formulary Version:
14
Contract Year:
2021
RXCUI:
545278
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104793
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1551300
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
104794
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1551306
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
104795
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058877
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
104796
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1745108
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104797
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
2395779
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
104798
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058887
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
104799
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
2370174
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
104800
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
2170613
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
30
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