Displaying 109021-109030 of 1611142 results.
ID:
109021
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
847348
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109022
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
847245
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109023
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197590
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109024
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197591
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109025
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197589
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109026
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197391
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109027
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197392
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109028
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
597852
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109029
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
597850
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109030
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
310273
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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