Displaying 114011-114020 of 1611142 results.
ID:
114011
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
198369
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
114012
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
198370
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
114013
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242819
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
56
ID:
114014
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242815
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
56
ID:
114015
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
616749
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
114016
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
728231
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
114017
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
2391560
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
114018
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1657212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
114019
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1735537
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
114020
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
992403
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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