Displaying 113001-113010 of 1611142 results.
ID:
113001
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
245314
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
113002
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
485968
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
113003
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
991061
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113004
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
857683
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113005
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000913
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113006
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
198202
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113007
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
857677
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113008
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1245443
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113009
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1245373
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113010
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
309329
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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