Displaying 109381-109390 of 1611142 results.
ID:
109381
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
307730
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109382
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
106302
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109383
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
884308
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
109384
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
106387
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109385
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
308714
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
109386
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
755497
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109387
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
992765
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109388
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
630208
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
109389
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
245314
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109390
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
485968
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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