Displaying 10381-10390 of 1611142 results.
		ID:
	10381	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	993536	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10382	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	852877	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10383	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	197979	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10384	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	197978	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10385	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1246306	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	30	
	
Qty Limit Days:
	30	
	
 
		ID:
	10386	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1246290	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	30	
	
Qty Limit Days:
	30	
	
 
		ID:
	10387	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1666334	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10388	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1116639	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10389	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1872261	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10390	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	2055008	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
 
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