Displaying 115801-115810 of 1611142 results.
ID:
115801
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653579
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115802
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
198148
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115803
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1797833
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
28
ID:
115804
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
1797844
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
15
Qty Limit Days:
10
ID:
115805
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
885857
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
115806
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
860901
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
200
Qty Limit Days:
30
ID:
115807
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
351265
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
115808
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
351266
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
115809
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
351267
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
115810
Formulary ID:
00021045
Formulary Version:
14
Contract Year:
2021
RXCUI:
905172
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
115801115802115803115804115805115806115807115808115809115810