Displaying 112481-112490 of 1611142 results.
ID:
112481
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110455
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
112482
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
904870
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
112483
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
904876
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
112484
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1314763
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112485
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
309047
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112486
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
312594
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112487
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
198141
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112488
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
834046
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112489
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
834040
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112490
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197536
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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