Displaying 42501-42510 of 1611142 results.
ID:
42501
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2103179
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
42502
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
810075
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42503
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
810079
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42504
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2284108
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
42505
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057205
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42506
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057216
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42507
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42508
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057219
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42509
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2099952
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
42510
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2105860
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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