Displaying 90391-90400 of 1611142 results.
ID:
90391
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1729311
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
28
ID:
90392
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055766
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90393
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1734642
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
90394
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1988671
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
90395
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1988675
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
90396
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1924315
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90397
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1486841
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90398
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
798300
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90399
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
830253
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90400
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
830245
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
90391903929039390394903959039690397903989039990400