Displaying 108701-108710 of 1611142 results.
ID:
108701
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
847745
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
108702
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1872980
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108703
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747577
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
108704
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747579
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
108705
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747567
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
108706
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747580
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108707
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921017
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108708
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921010
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108709
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921468
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108710
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
152971
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
108701108702108703108704108705108706108707108708108709108710