Displaying 115431-115440 of 1611142 results.
ID:
115431
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
904396
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
115432
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
199672
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115433
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
252559
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115434
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
239238
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115435
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
602393
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115436
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
432402
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
115437
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
477560
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115438
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
477562
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115439
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373497
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115440
Formulary ID:
00021043
Formulary Version:
14
Contract Year:
2021
RXCUI:
403875
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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