Displaying 113701-113710 of 1611142 results.
ID:
113701
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
858613
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113702
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
858616
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113703
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
858747
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113704
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1542997
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
113705
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1432969
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
113706
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
904880
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
113707
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
891881
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
113708
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
891888
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
113709
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
891893
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
113710
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
891874
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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