Displaying 109411-109420 of 1611142 results.
ID:
109411
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
996740
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
109412
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
311369
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
ID:
109413
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1482908
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109414
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806187
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
109415
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806189
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
109416
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806191
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
109417
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806193
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
109418
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
905369
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109419
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
311166
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109420
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197832
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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