Displaying 105251-105260 of 1611142 results.
ID:
105251
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1299896
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
105252
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
866090
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
105253
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
643066
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
105254
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1652084
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
105255
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1006801
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
105256
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
996921
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
105257
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
721773
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
105258
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
476179
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
105259
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
476177
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
105260
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
199703
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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