Displaying 109421-109430 of 1611142 results.
ID:
109421
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
349196
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
109422
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
349197
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
109423
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
905516
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109424
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
905495
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109425
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
835913
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109426
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000405
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109427
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
995232
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109428
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
977883
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109429
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197863
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109430
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
197556
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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