Displaying 104971-104980 of 1611142 results.
ID:
104971
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1874553
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
104972
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
900575
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104973
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
977427
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104974
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
977434
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104975
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
977438
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104976
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
892625
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
104977
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
311355
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104978
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
197893
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104979
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
313932
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
104980
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
309843
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
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