Displaying 110401-110410 of 1611142 results.
ID:
110401
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242819
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
56
ID:
110402
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242815
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
56
ID:
110403
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
616749
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
110404
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
728231
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
110405
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2391560
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
110406
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1657212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
110407
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1735537
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
110408
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
992403
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
110409
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1735496
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
110410
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1147228
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
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