Displaying 89241-89250 of 1611142 results.
ID:
89241
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
855626
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
89242
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
855194
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89243
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1607617
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
89244
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
311345
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89245
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
198200
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89246
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
349514
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
89247
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
351256
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89248
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
351257
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89249
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
310261
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
89250
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
308459
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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