Displaying 109081-109090 of 1611142 results.
ID:
109081
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055008
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109082
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
991233
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109083
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1098608
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109084
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
308047
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109085
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
308048
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109086
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197321
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109087
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197322
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
109088
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
198057
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109089
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
312134
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109090
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
198059
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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