Displaying 109011-109020 of 1611142 results.
ID:
109011
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2398842
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
109012
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1991311
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
109013
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1991317
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
109014
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200654
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
109015
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200658
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
109016
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200650
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
109017
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653204
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
28
ID:
109018
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
351926
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
40
Qty Limit Days:
28
ID:
109019
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
849851
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109020
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
847247
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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