Displaying 28501-28510 of 1611142 results.
ID:
28501
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
1356563
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
28502
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
1356572
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
28503
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
1356576
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
28504
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
1356580
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
28505
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
1356584
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
28506
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
1356588
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
28507
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
1790126
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
720
Qty Limit Days:
30
ID:
28508
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
824299
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
28509
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
824303
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
28510
Formulary ID:
00021008
Formulary Version:
14
Contract Year:
2021
RXCUI:
2054157
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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