Displaying 10871-10880 of 1611142 results.
		ID:
	10871	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	359296	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10872	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	308212	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10873	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	403810	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	4	
	
Qty Limit Days:
	28	
	
 
		ID:
	10874	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	403811	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	2	
	
Qty Limit Days:
	28	
	
 
		ID:
	10875	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1806195	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	30	
	
Qty Limit Days:
	30	
	
 
		ID:
	10876	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1806179	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	60	
	
Qty Limit Days:
	30	
	
 
		ID:
	10877	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1806183	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	30	
	
Qty Limit Days:
	30	
	
 
		ID:
	10878	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	308191	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10879	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	199119	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10880	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	864110	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
 
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