Displaying 109721-109730 of 1611142 results.
ID:
109721
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
995258
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109722
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1297753
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109723
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1297757
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109724
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
310992
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
109725
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049621
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
109726
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2101899
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
109727
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049683
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
109728
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049686
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
109729
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
109730
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
899557
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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