Displaying 203951-203960 of 1611142 results.
ID:
203951
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2100100
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203952
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2108930
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203953
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203954
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203955
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203956
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203957
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1923432
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203958
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
578018
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203959
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
477391
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203960
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
197877
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
200
Qty Limit Days:
30
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