Displaying 113501-113510 of 1611142 results.
ID:
113501
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
897683
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113502
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
314184
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113503
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
311918
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
9
Qty Limit Days:
30
ID:
113504
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
314135
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
9
Qty Limit Days:
30
ID:
113505
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
310537
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113506
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
897722
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113507
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197942
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113508
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197941
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113509
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
861007
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
113510
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
861010
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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