Displaying 111501-111510 of 1611142 results.
ID:
111501
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
1790317
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
111502
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
727714
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
111503
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
314230
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
111504
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
861646
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
111505
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
861650
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
111506
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
861654
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
111507
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
2123076
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
36
Qty Limit Days:
30
ID:
111508
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
349591
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
111509
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
349592
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
111510
Formulary ID:
00021042
Formulary Version:
14
Contract Year:
2021
RXCUI:
349593
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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