Displaying 112991-113000 of 1611142 results.
ID:
112991
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1300803
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112992
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
967388
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112993
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
307730
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112994
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
106302
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112995
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
884308
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
112996
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
106387
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112997
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
308714
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
112998
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
755497
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
112999
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
992765
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113000
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
630208
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
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