Displaying 109401-109410 of 1611142 results.
ID:
109401
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197634
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
109402
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
238154
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
109403
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
309844
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
ID:
109404
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
865117
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109405
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
865123
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109406
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
860918
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109407
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
859841
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109408
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
313159
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
30
ID:
109409
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197516
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109410
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197517
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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