Displaying 4301-4310 of 1611142 results.
ID:
4301
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
805515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
4302
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
603378
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
4303
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1190225
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
30
ID:
4304
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
580261
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
4305
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
836368
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
25
Qty Limit Days:
28
ID:
4306
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1552004
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
4307
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1723478
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
4308
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1430453
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
4309
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1430457
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
4310
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1100706
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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