Displaying 90771-90780 of 1611142 results.
ID:
90771
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
904876
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
90772
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1314763
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90773
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
309047
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90774
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
312594
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90775
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
198141
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90776
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
834046
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90777
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
834040
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90778
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197536
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
90779
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
429212
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
90780
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
309374
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
135
Qty Limit Days:
30
90771907729077390774907759077690777907789077990780