Displaying 106801-106810 of 1611142 results.
ID:
106801
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
2100099
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
106802
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
2100100
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
106803
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
106804
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
106805
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
ID:
106806
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
106807
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923432
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
106808
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
578018
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
106809
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
477391
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
106810
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
197877
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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