Displaying 89001-89010 of 1611142 results.
ID:
89001
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
799056
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89002
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
799054
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89003
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
206913
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89004
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
206917
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89005
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1657151
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
89006
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
994008
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
89007
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
900156
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89008
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
848582
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89009
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
824959
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89010
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
749206
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
89001890028900389004890058900689007890088900989010