Displaying 10391-10400 of 1611142 results.
		ID:
	10391	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	991233	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10392	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	308047	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	120	
	
Qty Limit Days:
	30	
	
 
		ID:
	10393	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	308048	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	120	
	
Qty Limit Days:
	30	
	
 
		ID:
	10394	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	197321	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	120	
	
Qty Limit Days:
	30	
	
 
		ID:
	10395	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	197322	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	150	
	
Qty Limit Days:
	30	
	
 
		ID:
	10396	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	198033	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10397	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	197444	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10398	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	197445	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10399	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	197816	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10400	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	197815	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
 
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