Displaying 42701-42710 of 1611142 results.
ID:
42701
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
905032
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
42702
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
1090996
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42703
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
197595
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42704
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
197596
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42705
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
309958
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42706
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
309960
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42707
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
884707
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
28
ID:
42708
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
753543
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
42709
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110455
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
42710
Formulary ID:
00021015
Formulary Version:
14
Contract Year:
2021
RXCUI:
1314763
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
42701427024270342704427054270642707427084270942710