Displaying 13221-13230 of 1611142 results.
ID:
13221
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
207100
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
13222
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
804547
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
13223
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307630
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
13224
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307635
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
13225
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
1243010
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
13226
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
1243014
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
13227
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601394
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
13228
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601386
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
13229
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601390
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
13230
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
1987734
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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