Displaying 104811-104820 of 1611142 results.
ID:
104811
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
207834
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104812
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1718936
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
104813
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1745114
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104814
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
729234
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104815
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
582971
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104816
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
582976
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104817
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1435117
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
104818
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
351859
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
40
Qty Limit Days:
28
ID:
104819
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1731317
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
24
Qty Limit Days:
28
ID:
104820
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
643177
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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