Displaying 109621-109630 of 1611142 results.
ID:
109621
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
864110
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109622
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
854302
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109623
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1793916
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
109624
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1657160
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
109625
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1654630
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
109626
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000007
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
ID:
109627
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
309339
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109628
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
309335
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109629
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
309336
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109630
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
308207
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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