Displaying 115201-115210 of 1611142 results.
ID:
115201
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
995599
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115202
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
995607
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115203
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
307650
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115204
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
616402
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
115205
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
309097
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115206
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
309098
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115207
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
835572
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115208
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
835591
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115209
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
835577
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115210
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
312940
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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