Displaying 116301-116310 of 1611142 results.
ID:
116301
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1246290
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
116302
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1666334
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
116303
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1116639
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
116304
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1872261
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
116305
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055008
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
116306
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
991233
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
116307
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1098608
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
116308
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
308047
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
116309
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
308048
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
116310
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
197321
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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