Displaying 10881-10890 of 1611142 results.
		ID:
	10881	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	854302	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10882	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1793916	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	4	
	
Qty Limit Days:
	28	
	
 
		ID:
	10883	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1657160	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	4	
	
Qty Limit Days:
	28	
	
 
		ID:
	10884	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1654630	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	30	
	
Qty Limit Days:
	30	
	
 
		ID:
	10885	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	2000007	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	0	
	
Qty Limit Amt:
	12	
	
Qty Limit Days:
	28	
	
 
		ID:
	10886	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	309339	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10887	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	309335	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10888	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	309336	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10889	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	308207	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
		ID:
	10890	
	Formulary ID:
	00021003	
	
Formulary Version:
	14	
	
Contract Year:
	2021	
	
RXCUI:
	1721475	
	
NDC:
		
	Tier Level:
	1	
	
Qty Limit?:
	1	
	
Qty Limit Amt:
	0	
	
Qty Limit Days:
	0	
	
 
 
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