Displaying 115401-115410 of 1611142 results.
ID:
115401
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
861668
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
115402
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
830795
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115403
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
831359
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115404
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
801957
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115405
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
801961
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115406
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
801966
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115407
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
245723
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115408
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
830861
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115409
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
830845
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115410
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
830837
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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