Displaying 113901-113910 of 1611142 results.
ID:
113901
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307061
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
113902
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115698
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
180
ID:
113903
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1308569
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
113904
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
351209
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113905
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
310362
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113906
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
197623
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113907
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055650
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
113908
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099808
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113909
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1484296
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
113910
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1190919
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
113901113902113903113904113905113906113907113908113909113910