Displaying 34201-34210 of 1611142 results.
ID:
34201
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
311995
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
34202
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
1648759
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
34203
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307061
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
34204
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115698
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
180
ID:
34205
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
1308569
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
34206
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
351209
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
34207
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
197623
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
34208
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055650
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
34209
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099808
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
34210
Formulary ID:
00021010
Formulary Version:
14
Contract Year:
2021
RXCUI:
1484296
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
34201342023420334204342053420634207342083420934210