Displaying 104821-104830 of 1611142 results.
ID:
104821
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
643173
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
104822
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
643175
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104823
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
799830
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104824
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1045408
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104825
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1045404
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104826
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364441
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104827
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364447
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
104828
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1145932
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104829
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1799230
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104830
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1925255
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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