Displaying 115091-115100 of 1611142 results.
ID:
115091
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1856424
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115092
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
2052064
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115093
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
861375
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115094
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
861370
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115095
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373745
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115096
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
485442
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
115097
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
485465
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
115098
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
352066
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
115099
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
656660
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
115100
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1989085
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
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