Displaying 109511-109520 of 1611142 results.
ID:
109511
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
897630
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109512
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
312025
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109513
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
198041
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109514
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
582926
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109515
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1597123
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
109516
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1597129
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
109517
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
238134
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
109518
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1745091
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
109519
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1801289
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109520
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
994237
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
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