Displaying 13811-13820 of 1611142 results.
ID:
13811
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
603208
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
13812
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
603203
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
13813
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
603206
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
13814
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
748961
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
13815
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
751901
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
84
ID:
13816
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
810096
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
84
ID:
13817
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
749761
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
84
ID:
13818
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
748868
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
13819
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
759743
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
13820
Formulary ID:
00021004
Formulary Version:
14
Contract Year:
2021
RXCUI:
748806
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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