Displaying 113401-113410 of 1611142 results.
ID:
113401
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197650
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113402
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091155
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
113403
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091170
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
113404
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091185
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
113405
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091210
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
113406
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
808751
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
113407
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
808753
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
113408
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
808744
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
113409
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
861601
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113410
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
861597
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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