Displaying 117101-117110 of 1611142 results.
ID:
117101
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
197636
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
117102
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
260243
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
117103
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
312641
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
117104
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1312625
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
117105
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1365660
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
117106
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1365847
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
117107
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1365850
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
117108
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1928954
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
117109
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1090641
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
117110
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
905222
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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