Displaying 112701-112710 of 1611142 results.
ID:
112701
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
312134
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
112702
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
198059
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
112703
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
198033
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112704
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197444
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112705
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197445
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112706
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197816
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112707
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197815
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112708
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1001004
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112709
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
351264
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
112710
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
904605
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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