Displaying 108241-108250 of 1611142 results.
ID:
108241
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099681
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108242
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
197682
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108243
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
866910
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108244
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
308867
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108245
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1092357
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108246
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665473
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
108247
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798370
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
108248
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798375
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
108249
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
200132
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
108250
Formulary ID:
00021040
Formulary Version:
14
Contract Year:
2021
RXCUI:
199149
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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