Displaying 108871-108880 of 1611142 results.
ID:
108871
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
904876
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
108872
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1314763
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108873
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
309047
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108874
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
312594
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108875
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
198141
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108876
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
834046
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108877
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
834040
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
108878
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197536
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
108879
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
429212
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
108880
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
309374
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
135
Qty Limit Days:
30
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