Displaying 104861-104870 of 1611142 results.
ID:
104861
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1734642
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104862
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1988671
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
104863
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1988675
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
104864
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1924315
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104865
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1486841
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104866
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
798300
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104867
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
830253
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104868
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
830245
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104869
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
836636
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104870
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
836634
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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