Displaying 48931-48940 of 1611142 results.
ID:
48931
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000500
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
48932
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000487
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
48933
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653579
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
48934
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
198148
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
48935
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
1797833
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
28
ID:
48936
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
1797844
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
15
Qty Limit Days:
10
ID:
48937
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
885857
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
48938
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
860901
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
200
Qty Limit Days:
30
ID:
48939
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
351265
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
48940
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
351266
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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